Individual
LESLIE DIRISIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA
Contact information
Practice address
1561 LONG POND RD, SUITE 408, ROCHESTER, NY 14626-4117
(585) 442-4141
(585) 442-6259
Mailing address
1561 LONG POND RD, SUITE 408, ROCHESTER, NY 14626-4117
(585) 442-4141
(585) 442-6259
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006737
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02507835
—
NY
Enumeration date
07/13/2006
Last updated
05/06/2016
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