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WATERTOWN MEDICAL OPTICAL PLLC NPI 1730203548


NPI Information

NPI: 1730203548
Provider Name: WATERTOWN MEDICAL OPTICAL PLLC

Doing Business As: NOAMAN SANNI DBA WATERTOWN MEDICAL OPTICAL PLLC

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
1815 STATE STREET
WATERTOWN, NY
ZIP 13601
Phone: (315) 786-8064
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WATERTOWN MEDICAL OPTICAL PLLC is an eyewear supplier in Watertown, NY. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. WATERTOWN MEDICAL OPTICAL PLLC NPI is 1730203548. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Noaman Sanni Dba Watertown Medical Optical Pllc.

The provider's business location address is:

1815 STATE STREET
WATERTOWN, NY
ZIP 13601
Phone: (315) 786-8064
Fax: (315) 788-1950

The provider's authorized official is Noaman Sanni .
The authorized official title is Owner and has the following contact phone number (315) 788-6070.

The enumeration date for this NPI number is 3/19/2007 and was last updated on 4/15/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristVUT0053871NEW YORKNo
2207W00000XOphthalmology2060481NEW YORKNo
3207W00000XOphthalmologyNo
4332H00000XEyewear SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11276770001MEDICARE ID-TYPE UNSPECIFIEDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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