Individual
NICHOLAS JOHN LEONARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2865 N REYNOLDS RD, SUITE 230, TOLEDO, OH 43615-2068
(419) 578-4367
(419) 537-5639
Mailing address
6591 W CENTRAL AVE, SUITE 202, TOLEDO, OH 43617-1087
(419) 517-6599
(419) 517-0503
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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