Basic Information
| Provider Information | |||||||||
| NPI: | 1003147307 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURABITO | ||||||||
| FirstName: | LEANNE | ||||||||
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| Credential: | REG. DISPENSING OPTI | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3005 | ||||||||
| Address2: | |||||||||
| City: | EAST HAMPSTEAD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033821195 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 265 EAST MAIN STREET | ||||||||
| Address2: | UNIT 5 | ||||||||
| City: | EAST HAMPSTEAD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6033821195 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2010 | ||||||||
| LastUpdateDate: | 01/26/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 156FX1800X | 100 | NH | Y | Eye and Vision Services Providers | Technician/Technologist | Optician |
No ID Information.