Provider Demographics
NPI:1245218007
Name:BOYEK, LEONARD J (OD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:J
Last Name:BOYEK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:PA
Mailing Address - Zip Code:18651-3016
Mailing Address - Country:US
Mailing Address - Phone:570-779-1464
Mailing Address - Fax:570-938-0003
Practice Address - Street 1:1 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:PA
Practice Address - Zip Code:18651-3016
Practice Address - Country:US
Practice Address - Phone:570-779-1464
Practice Address - Fax:570-938-0003
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000444152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
818640OtherFIRST PRIORITY
PA410004452OtherPALMETTO GBA RAILROAD MED
558037OtherUS HEALTHCARE
PA20655OtherGEISINGER HEALTH
PA1874500001Medicare NSC
PA286996Medicare PIN
PA20655OtherGEISINGER HEALTH
558037OtherUS HEALTHCARE