Healthcare Provider Details

I. General information

NPI: 1376409128
Provider Name (Legal Business Name): OCULAR CARE PROSTHETICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MANSFIELD DR
ENDICOTT NY
13760-4272
US

IV. Provider business mailing address

18 MANSFIELD DR
ENDICOTT NY
13760-4272
US

V. Phone/Fax

Practice location:
  • Phone: 607-752-3716
  • Fax:
Mailing address:
  • Phone: 607-752-3716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: SHARON LARSON
Title or Position: FOUNDER/OCULARIST
Credential:
Phone: 607-752-3716