Healthcare Provider Details

I. General information

NPI: 1669936191
Provider Name (Legal Business Name): NILES CENTER FOR SIGHT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 ROBBINS AVE STE C
NILES OH
44446-1769
US

IV. Provider business mailing address

234 ROBBINS AVE STE C
NILES OH
44446-1769
US

V. Phone/Fax

Practice location:
  • Phone: 330-951-6674
  • Fax:
Mailing address:
  • Phone: 330-574-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: KENNETH M KUHN
Title or Position: OWNER
Credential: OD
Phone: 330-574-5030