MEDICARE: DR. LYNN LEBLANC DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	000530	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
15	480000912	OTHER	CT	MEDICARE PROVIDER ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1093710972	OTHER	CT	NPI
2	030000530CT04	OTHER	CT	FEDERAL BLUE CROSS ID
3	PL0161	OTHER	CT	MEDIBLUE PROVIDER ID
4	3204678	OTHER	CT	AETNA PROVIDER ID
5	748411	OTHER	CT	CONNECTICARE PROVIDER ID
6	1162763	OTHER	CT	UNITED HEALTH PROVIDER ID
7	030000530CT04	OTHER	CT	ANTHEM PROVIDER ID
8	1396931648	OTHER	CT	NPI
9	298258	OTHER	CT	WELLCARE PROVIDER ID
10	2V4184	OTHER	CT	HEALTH NET PROVIDER ID
11	HAS386	OTHER	CT	OXFORD PROVIDER ID
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	0170716	OTHER	CT	CIGNA PROVIDER ID
14	1235281288	OTHER	CT	GROUP NPI

General Provider Information

NPI Number	:	1093710972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNN LEBLANC DPM

Provider Business Mailing Address
First Line	:	1 NORTHWESTERN DR
Second Line	:	SUITE 301
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3400
Country	:	US
Telephone Number	:	860-243-2951
Fax Number	:	860-243-5790

Provider Business Practice Location Address
First Line	:	1 NORTHWESTERN DR
Second Line	:	SUITE 301
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3400
Country	:	US
Telephone Number	:	860-243-2951
Fax Number	:	860-243-5790

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	10/30/2014

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Directions to “ DR. LYNN LEBLANC DPM” Practice Location

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