Provider Demographics
NPI:1174343404
Name:SCANIO, LEAH NOELLE (DC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:NOELLE
Last Name:SCANIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 EISENHOWER AVE
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:NY
Mailing Address - Zip Code:14006-9155
Mailing Address - Country:US
Mailing Address - Phone:716-863-6556
Mailing Address - Fax:
Practice Address - Street 1:5500 MAIN STREET
Practice Address - Street 2:SUITE #301
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-863-6556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX01383801111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor