Individual
TERESEA G. LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
128 NORTH AVE, OWEGO, NY 13827-1304
(607) 687-6101
(607) 687-5994
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
336010
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03177548
—
NY
Enumeration date
10/06/2009
Last updated
09/14/2011
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