Healthcare Provider Details

I. General information

NPI: 1689623993
Provider Name (Legal Business Name): OPTOMETRIC PROVIDERS OF NEW HAMPSHIRE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

346 S BROADWAY ROUTE 28
SALEM NH
03079-4304
US

IV. Provider business mailing address

2921 ERIE BLVD E OPTOMETRIC PROVIDERS OF NEW HAMPSHIRE, P.C.
SYRACUSE NY
13224-1430
US

V. Phone/Fax

Practice location:
  • Phone: 603-898-8560
  • Fax: 603-870-9271
Mailing address:
  • Phone: 315-445-7465
  • Fax: 315-445-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RANDI FRANKL
Title or Position: PRESIDENT
Credential: OD
Phone: 516-815-1646