Provider Demographics
NPI:1275514556
Name:STEINER, LEONARD MARVIN (OD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:MARVIN
Last Name:STEINER
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 1:780 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1014
Mailing Address - Country:US
Mailing Address - Phone:732-531-6300
Mailing Address - Fax:732-531-9149
Practice Address - Street 1:780 W PARK AVE
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1014
Practice Address - Country:US
Practice Address - Phone:732-531-6300
Practice Address - Fax:732-531-9149
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00385300152W00000X
NJ27TO00001200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU26867Medicare UPIN
NJ521332Medicare ID - Type Unspecified