Provider Demographics
NPI:1255568317
Name:LEBLANC, ALLISON M (OD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:M
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 POSNEGANSETT AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3500
Mailing Address - Country:US
Mailing Address - Phone:315-250-0552
Mailing Address - Fax:
Practice Address - Street 1:7805 POST RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4405
Practice Address - Country:US
Practice Address - Phone:401-294-1010
Practice Address - Fax:401-295-2050
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5331152W00000X
390200000X
RIODTG00670152W00000X
NYTUV007422152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program