Individual
JENNA NICOLE LEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV-007838
NY
390200000X
Student in an Organized Health Care Education/Training Program
TUV-007838-1
NY
Other
Enumeration date
07/29/2012
Last updated
10/05/2022
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