Provider Demographics
NPI:1831102292
Name:THE LEONA CORP
Entity Type:Organization
Organization Name:THE LEONA CORP
Other - Org Name:ALTMAN ORTHOTICS & PROSTHETICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:855-425-8626
Mailing Address - Street 1:638 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-3053
Mailing Address - Country:US
Mailing Address - Phone:855-425-8626
Mailing Address - Fax:860-563-3120
Practice Address - Street 1:638 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-3053
Practice Address - Country:US
Practice Address - Phone:855-425-8626
Practice Address - Fax:860-563-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT795131OtherCONNECTICARE
CT004218708Medicaid
CT12DME0157CT01OtherBLUE CROSS BLUE SHIELD
CT004218708Medicaid