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Individual

DIANE I LEGENDRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, RPAC

Contact information

Practice address
130 CENTER WAY, CORNING, NY 14830-2255
(607) 936-9971
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006379-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000063791
NY
Enumeration date
11/02/2005
Last updated
03/11/2021
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