Provider Demographics
NPI:1649306275
Name:LEGGIN, PATRICIA (OD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:LEGGIN
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 1:284 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:
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:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA05374152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ602148OtherAETNA
NJ954677P72Medicare ID - Type Unspecified
NJ602148OtherAETNA