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NPI Code Detail

MEDICARE: DR. NEIL F. HENNINGER O.D.

MEDICARE:  DR. NEIL F. HENNINGER  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristTUV-005362-1NY

General Provider Information

NPI Number : 1174521579
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NEIL F. HENNINGER O.D.
Provider Business Mailing Address
First Line : PO BOX 474
Second Line :
City : TRUMANSBURG
State : NY
Zip : 14886-0474
Country : US
Telephone Number : 607-387-7327
Fax Number : 607-387-3500
Provider Business Practice Location Address
First Line : 11 E MAIN ST
Second Line :
City : TRUMANSBURG
State : NY
Zip : 14886
Country : US
Telephone Number : 607-387-7327
Fax Number : 607-387-3500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2005
Last Update Date : 07/15/2008

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Directions to “ DR. NEIL F. HENNINGER O.D.” Practice Location

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