Provider Demographics
NPI:1497923775
Name:LEANE E. DELBALSO, O.D.
Entity Type:Organization
Organization Name:LEANE E. DELBALSO, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:O.D.
Authorized Official - Prefix:
Authorized Official - First Name:LEANE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:DELBALSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-822-2568
Mailing Address - Street 1:2150 WILKES BARRE TOWNSHIP MARKET PL
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-6059
Mailing Address - Country:US
Mailing Address - Phone:570-822-2568
Mailing Address - Fax:570-822-2798
Practice Address - Street 1:2150 WILKES BARRE TOWNSHIP MARKET PL
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6059
Practice Address - Country:US
Practice Address - Phone:570-822-2568
Practice Address - Fax:570-822-2798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty