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General NPI Number Information
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NPI Number | 1487735858
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Entity Type | Individual
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Provider Name | NICHOLAS LEONE M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 39400 GARFIELD RD SUITE 103
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-4096
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Country | US
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Telephone | 586-286-6550
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Fax | 586-286-1843
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Provider Business Mailing Address
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Address Line | 39400 GARFIELD RD SUITE 103
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-4096
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Country | US
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Telephone | 586-286-6550
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Fax | 586-286-1843
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301057966
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License Number State | MI
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