Healthcare Provider Details

I. General information

NPI: 1215225263
Provider Name (Legal Business Name): D&B OPTOMETRY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2011
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 STATE ROUTE 104 VISION CENTER
OSWEGO NY
13126
US

IV. Provider business mailing address

9602 DUNDERRY HTS
BALDWINSVILLE NY
13027-9082
US

V. Phone/Fax

Practice location:
  • Phone: 315-207-7044
  • Fax: 315-343-5165
Mailing address:
  • Phone: 315-720-3988
  • Fax: 315-652-4819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6120TUV
License Number StateNY

VIII. Authorized Official

Name: DANIEL PISACANO
Title or Position: ORGANIZING MEMBER
Credential: O.D.
Phone: 315-720-3988