Individual
KEVIN T LE ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
110 W 6TH ST, OSWEGO, NY 13126-2507
(315) 349-5511
(315) 349-5732
Mailing address
5100 W TAFT RD, SUITE 1C, LIVERPOOL, NY 13088-3807
(315) 452-2333
(315) 452-2336
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
335967
NY
363L00000X
Nurse Practitioner
Primary
335967
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03133180
—
NY
Enumeration date
07/01/2009
Last updated
04/09/2012
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