Provider Demographics
NPI:1972735199
Name:STRONG, SUZANNE LESLIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LESLIE
Last Name:STRONG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:LESLIE
Other - Last Name:MARCHESSAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 N TRANSIT ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-3601
Mailing Address - Country:US
Mailing Address - Phone:716-433-0367
Mailing Address - Fax:716-433-2559
Practice Address - Street 1:5 N TRANSIT ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-3601
Practice Address - Country:US
Practice Address - Phone:716-433-0367
Practice Address - Fax:716-433-2559
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044810183500000X
CT8404183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist