Provider Demographics
NPI:1386603546
Name:LEONARD, THOMAS P (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:LEONARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 HADDON AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3714
Mailing Address - Country:US
Mailing Address - Phone:856-858-1264
Mailing Address - Fax:
Practice Address - Street 1:1030 ARCH ST
Practice Address - Street 2:1ST FL
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3011
Practice Address - Country:US
Practice Address - Phone:215-592-8111
Practice Address - Fax:215-592-0758
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE6131T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOE6131TOtherSTATE LICENSE
PA0217640002Medicare ID - Type Unspecified