National Provider Identifier
Audra A Leboo, MBCHB
Audra A Leboo, MBCHB is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Honeoye Falls, NY and a listed phone number of (585) 624-2121.
Profile Overview
- NPI
- 1114161239
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- April 21, 2009
- Last Updated
- August 16, 2024
Practice Location
- 23 Ontario St
- Honeoye Falls, NY 14472-1149
Phone: (585) 624-2121
Mailing Address
- 300 West Ave
- Brockport, NY 14420-1118
Specialties
- Family Medicine Physician (207Q00000X)
Full Record
- NPI
- 1114161239
- Entity Type
- Individual
- Last Name
- Leboo
- First Name
- Audra
- Middle Name
- A
- Name Prefix
- Dr.
- Credential
- MBCHB
- Mailing Street Address
- 300 West Ave
- Mailing City
- Brockport
- Mailing State
- NY
- Mailing ZIP Code
- 14420-1118
- Mailing Country
- US
- Mailing Phone
- (585) 637-3905
- Mailing Fax
- (585) 637-4990
- Practice Street Address
- 23 Ontario St
- Practice City
- Honeoye Falls
- Practice State
- NY
- Practice ZIP Code
- 14472-1149
- Practice Country
- US
- Practice Phone
- (585) 624-2121
- Practice Fax
- (585) 624-7283
- Enumeration Date
- April 21, 2009
- Last Updated
- August 16, 2024
- Deactivation Date
- August 01, 2024
- Reactivation Date
- August 16, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- April 16, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X)