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General NPI Number Information
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NPI Number | 1376778779
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Entity Type | Organization
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Legal Business Name | KENNETH BRAUNSTEIN
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 06/12/2009
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Provider Practice Location Address
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Address Line | 20 S BROADWAY
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City | YONKERS
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State | NY
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Zip | 10701-3713
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Country | US
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Telephone | 914-963-9787
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Fax |
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Provider Business Mailing Address
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Address Line | 20 S BROADWAY
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City | YONKERS
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State | NY
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Zip | 10701-3713
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Country | US
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Telephone | 914-963-9787
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. KENNETH H. BRAUNSTEIN
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Credential | O.D.
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Telephone | 914-963-9787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV003316
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License Number State | NY
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