Provider Demographics
NPI:1184907818
Name:DR. PATRICIA LEGGIN, OD PRIMARY EYECARE
Entity type:Organization
Organization Name:DR. PATRICIA LEGGIN, OD PRIMARY EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGGIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:908-432-6391
Mailing Address - Street 1:284 ROUTE 206
Mailing Address - Street 2:BUILDING E, SUITE 8
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4690
Mailing Address - Country:US
Mailing Address - Phone:908-359-1210
Mailing Address - Fax:908-359-1821
Practice Address - Street 1:284 ROUTE 206
Practice Address - Street 2:BUILDING E, SUITE 8
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4690
Practice Address - Country:US
Practice Address - Phone:908-359-1210
Practice Address - Fax:908-359-1821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00537402152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty