Provider Demographics
NPI:1730359811
Name:THE LEONA CORP
Entity type:Organization
Organization Name:THE LEONA CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:CO
Authorized Official - Phone:860-716-7166
Mailing Address - Street 1:270 FARMINGTON AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1909
Mailing Address - Country:US
Mailing Address - Phone:860-633-5557
Mailing Address - Fax:860-633-5558
Practice Address - Street 1:270 FARMINGTON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1909
Practice Address - Country:US
Practice Address - Phone:860-633-5557
Practice Address - Fax:860-633-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4415280001Medicare NSC