Healthcare Provider Details

I. General information

NPI: 1780620948
Provider Name (Legal Business Name): AUGUST PATRICK SINICROPI O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 E BAYARD ST
SENECA FALLS NY
13148-1640
US

IV. Provider business mailing address

122 E BAYARD ST
SENECA FALLS NY
13148-1640
US

V. Phone/Fax

Practice location:
  • Phone: 315-568-6991
  • Fax: 315-568-8454
Mailing address:
  • Phone: 315-568-6991
  • Fax: 315-568-8454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV003041-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: