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General NPI Number Information
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NPI Number | 1003942434
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Entity Type | Organization
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Legal Business Name | SAMUEL A. SEBASTIAN & GENE HRYCAK DBA OPTICAL VISION OF YOUNGSTOWN
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 2959 CANFIELD RD SUITE #1
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City | YOUNGSTOWN
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State | OH
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Zip | 44511-2800
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Country | US
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Telephone | 330-792-7045
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Fax | 330-792-0038
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Provider Business Mailing Address
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Address Line | 2959 CANFIELD RD SUITE #1
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City | YOUNGSTOWN
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State | OH
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Zip | 44511-2800
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Country | US
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Telephone | 330-792-7045
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Fax | 330-792-0038
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Authorized Official
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Title or Position | PARTNER
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Name | MR. SAMUEL A SEBASTIAN
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Credential | OPTICIAN
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Telephone | 330-792-7045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | SC 198
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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