Provider Demographics
NPI:1861528531
Name:LEONARD M STEIN OD LLC
Entity type:Organization
Organization Name:LEONARD M STEIN OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD, FAAO
Authorized Official - Phone:734-591-2020
Mailing Address - Street 1:20000 HAGGERTY ROAD
Mailing Address - Street 2:LOCATED INSIDE COSTCO
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1011
Mailing Address - Country:US
Mailing Address - Phone:734-591-2020
Mailing Address - Fax:734-853-1278
Practice Address - Street 1:20000 HAGGERTY RD
Practice Address - Street 2:LOCATED INSIDE COSTCO
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1011
Practice Address - Country:US
Practice Address - Phone:734-591-2020
Practice Address - Fax:734-853-1278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002380152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty