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General NPI Number Information
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NPI Number | 1225942014
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Entity Type | Organization
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Legal Business Name | SQUARE DEAL OPTICAL SUPPLY
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 11 COURT ST
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City | BINGHAMTON
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State | NY
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Zip | 13901-3101
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Country | US
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Telephone | 607-743-8039
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Fax | 607-724-2222
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Provider Business Mailing Address
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Address Line | 52 FOWLER AVE
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City | JOHNSON CITY
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State | NY
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Zip | 13790-2910
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Country | US
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Telephone | 607-427-2735
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Fax | 607-724-2222
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Authorized Official
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Title or Position | OPTICIAN
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Name | CHRISTOPHER JOSEPH WELCH
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Credential |
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Telephone | 607-427-2735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | NULL
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