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General NPI Number Information
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NPI Number | 1295081149
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Entity Type | Organization
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Legal Business Name | SIRGANY EYECARE LLC
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 992 STATE RTE 13
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City | CORTLAND
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State | NY
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Zip | 13045
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Country | US
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Telephone | 607-749-2020
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Fax | 607-749-2220
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Provider Business Mailing Address
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Address Line | 992 STATE ROUTE 13
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City | CORTLAND
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State | NY
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Zip | 13045
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Country | US
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Telephone | 607-749-2020
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Fax | 607-749-2220
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN J SIRGANY
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Credential | OD
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Telephone | 607-749-2020
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV 006874
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License Number State | NY
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