MEDICARE: DR. LAWRENCE LEFLAND O.D.

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	152W00000X	Optometrist	924	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	554936	OTHER	CT	CONNECTICARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	998134	OTHER	CT	AETNA
4	OV1037	OTHER	CT	HEALTHNET
5	090000924-CT05	OTHER	CT	ANTHEM

General Provider Information

NPI Number	:	1619995214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE LEFLAND O.D.

Provider Business Mailing Address
First Line	:	81A WASHINGTON AVE
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-1704
Country	:	US
Telephone Number	:	203-985-9000
Fax Number	:	203-985-9210

Provider Business Practice Location Address
First Line	:	81A WASHINGTON AVE
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-1704
Country	:	US
Telephone Number	:	203-985-9000
Fax Number	:	203-985-9210

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	01/24/2011

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