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NPI Code Detail

MEDICARE: DR. LEONARD J GOLDSTEIN OD

MEDICARE:  DR. LEONARD J GOLDSTEIN  OD
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
1152W00000XOptometristTUV002947NY

General Provider Information

NPI Number : 1578749032
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEONARD J GOLDSTEIN OD
Provider Business Mailing Address
First Line : 2921 ERIE BLVD E
Second Line : EMPIRE VISION CENTER, INC
City : SYRACUSE
State : NY
Zip : 13224-1430
Country : US
Telephone Number : 315-446-3145
Fax Number : 315-445-7675
Provider Business Practice Location Address
First Line : 3039 ROUTE 50
Second Line : EMPIRE VISION CENTERS
City : SARATOGA SPRINGS
State : NY
Zip : 12866-2937
Country : US
Telephone Number : 518-580-1117
Fax Number : 518-580-1311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2008
Last Update Date : 01/15/2008

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