Provider Demographics
NPI:1356323372
Name:LENAHAN FINKBEINER, LESLEY LYNN
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:LYNN
Last Name:LENAHAN FINKBEINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LESLEY
Other - Middle Name:LYNN
Other - Last Name:LENAHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2186 PEACH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9361
Mailing Address - Country:US
Mailing Address - Phone:989-220-5506
Mailing Address - Fax:989-345-1281
Practice Address - Street 1:304 W HOUGHTON AVE
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-1222
Practice Address - Country:US
Practice Address - Phone:989-345-2020
Practice Address - Fax:989-345-1281
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003637152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4423159Medicaid
MI0356290004OtherMEDICARE DURABLE MEDICAL
U52100Medicare UPIN
MI0F56321004Medicare PIN