Healthcare Provider Details

I. General information

NPI: 1346333135
Provider Name (Legal Business Name): DRS. CHASIN & GUARENTE, OPTOMETRISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 LUCAS AVE
KINGSTON NY
12401-4316
US

IV. Provider business mailing address

240 LUCAS AVE
KINGSTON NY
12401-4316
US

V. Phone/Fax

Practice location:
  • Phone: 845-339-4990
  • Fax: 845-339-5001
Mailing address:
  • Phone: 845-339-4990
  • Fax: 845-339-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV3749
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. AUGUSTUS GUARENTE
Title or Position: VICE PRESIDENT
Credential: O.D.
Phone: 845-339-4990