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Individual
NICHOLAS JOHN LEONARDY
Active
Individual
NICHOLAS JOHN LEONARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35062682
OH
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
35062682
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000026371
ANTHEM
OH
05
—
0852439
—
OH
01
—
341196311
TAX IDENTIFICATION NUMBER
—
01
—
LE0704641
PTAN
—
Enumeration date
02/27/2006
Last updated
04/05/2017
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