Healthcare Provider Details

I. General information

NPI: 1437445053
Provider Name (Legal Business Name): CZINDER EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 ELM ST
BIG RAPIDS MI
49307-1813
US

IV. Provider business mailing address

303 ELM ST
BIG RAPIDS MI
49307-1813
US

V. Phone/Fax

Practice location:
  • Phone: 231-796-6604
  • Fax: 231-796-0688
Mailing address:
  • Phone: 231-796-6604
  • Fax: 231-796-0688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901002299
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4901002299
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number4901002299
License Number StateMI

VIII. Authorized Official

Name: JOSEPH CZINDER
Title or Position: OWNER
Credential: OD
Phone: 231-796-6604