Provider Demographics
NPI:1013279496
Name:KAMMERDIENER, LEAH LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:LYNN
Last Name:KAMMERDIENER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 STATE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-3319
Mailing Address - Country:US
Mailing Address - Phone:774-320-3040
Mailing Address - Fax:508-910-2204
Practice Address - Street 1:566 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2799
Practice Address - Country:US
Practice Address - Phone:401-738-4800
Practice Address - Fax:401-738-5183
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34779207W00000X
FLME129068207W00000X
SCLL 34779208600000X
RIMD18779207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No208600000XAllopathic & Osteopathic PhysiciansSurgery