Provider Demographics
NPI:1619995214
Name:LEFLAND, LAWRENCE (OD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:LEFLAND
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 1:81A WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-1704
Mailing Address - Country:US
Mailing Address - Phone:203-985-9000
Mailing Address - Fax:203-985-9210
Practice Address - Street 1:81A WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1704
Practice Address - Country:US
Practice Address - Phone:203-985-9000
Practice Address - Fax:203-985-9210
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT924152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT554936OtherCONNECTICARE
CT4048575Medicaid
CT998134OtherAETNA
CTOV1037OtherHEALTHNET
CT090000924-CT05OtherANTHEM
CTOV1037OtherHEALTHNET
CT998134OtherAETNA
CT4048575Medicaid