Wilderson, Leslie Rand
Wilderson, Leslie Rand is an sole proprietor health care provider with primary practice located at 1250 Baltimore Pike Pearle Vision, Springfield PA 19064-2706. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Wilderson, Leslie Rand can be contacted via phone (610) 544-1841.Contact Information
Primary practice address
1250 Baltimore Pike Pearle Vision
Springfield PA 19064-2706
Phone: (610) 544-1841
Fax: (610) 544-2984
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OET008830 | Pennsylvania |
Profile Details
| NPI number | 1578572442 |
|---|---|
| LBN Legal business name | Wilderson, Leslie Rand |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 7th, 2006 |
| Last updated | Oct 3rd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578572442 | NPPES |
| Pennsylvania | MEDICAID | PENDING |
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