Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | I3-0001413 | DE |
Y | 152W00000X | Optometrist | OEG001543 | PA |
NPI | 1003811183 |
---|---|
Provider Name | Dr. Lea Ann Menear |
First Address | Aldan, PA 19018-3707 |
Second Address | Wilmington, DE 19808-1652 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 07/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V00849 | (02) | PA |