Provider Demographics
NPI:1255526919
Name:JOSEPH J. LEINWAND
Entity type:Organization
Organization Name:JOSEPH J. LEINWAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:LEINWAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-876-8181
Mailing Address - Street 1:1301 E MILLBROOK RD
Mailing Address - Street 2:SUITE D-100
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5481
Mailing Address - Country:US
Mailing Address - Phone:919-876-8181
Mailing Address - Fax:919-876-8104
Practice Address - Street 1:1301 E MILLBROOK RD
Practice Address - Street 2:SUITE D-100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5481
Practice Address - Country:US
Practice Address - Phone:919-876-8181
Practice Address - Fax:919-876-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC0953332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0912LOtherBCBS
NCNC0953OtherSUPERIOR VISION
10530OtherSPECTERA
NC890912LMedicaid
246253DMedicare PIN