MEDICARE: DR. MARK JAMES CINALLI OD

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
1	152WC0802X	Corneal and Contact Management Optometrist	WV759OD	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376508549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK JAMES CINALLI OD

Provider Business Mailing Address
First Line	:	229 PLANTATION DR
Second Line	:
City	:	MINERAL WELLS
State	:	WV
Zip	:	26150-9638
Country	:	US
Telephone Number	:	304-489-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	416 DIVISION ST
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26101-5619
Country	:	US
Telephone Number	:	304-485-7485
Fax Number	:	304-485-5410

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	07/09/2007

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