Provider Demographics
NPI:1003147307
Name:MURABITO, LEANNE (REG DISPENSING OPTI)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:MURABITO
Suffix:
Gender:F
Credentials:REG DISPENSING OPTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3005
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPSTEAD
Mailing Address - State:NH
Mailing Address - Zip Code:03826
Mailing Address - Country:US
Mailing Address - Phone:603-382-1195
Mailing Address - Fax:
Practice Address - Street 1:265 EAST MAIN STREET
Practice Address - Street 2:UNIT 5
Practice Address - City:EAST HAMPSTEAD
Practice Address - State:NH
Practice Address - Zip Code:03826
Practice Address - Country:US
Practice Address - Phone:603-382-1195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH100156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician