Provider Demographics
NPI:1124196118
Name:DONDE, LEONARD (OD)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:
Last Name:DONDE
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 1:453 KINGS HWY
Mailing Address - Street 2:MODERN OPTICAL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1847
Mailing Address - Country:US
Mailing Address - Phone:718-336-1060
Mailing Address - Fax:
Practice Address - Street 1:453 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1803
Practice Address - Country:US
Practice Address - Phone:718-336-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0071631-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician