Provider Demographics
NPI:1780946624
Name:LEICHTENBERGER, ASHLEY N (OD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:N
Last Name:LEICHTENBERGER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:N
Other - Last Name:LEICHTENBERGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:560 MILLCREEK MALL # 400
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16565-0502
Mailing Address - Country:US
Mailing Address - Phone:814-868-8540
Mailing Address - Fax:
Practice Address - Street 1:560 MILLCREEK MALL # 400
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16565-0502
Practice Address - Country:US
Practice Address - Phone:814-868-8540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002607152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist