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General NPI Number Information
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NPI Number | 1548363930
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Entity Type | Individual
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Provider Name | AMIR MINASAZI OD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 4350 MIDDLE SETTLEMENT RD DOVE EYE CENTER
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City | NEW HARTFORD
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State | NY
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Zip | 13413
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Country | US
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Telephone | 315-733-2020
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Fax | 315-735-3628
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Provider Business Mailing Address
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Address Line | 4350 MIDDLE SETTLEMENT RD DOVE EYE CENTER
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City | NEW HARTFORD
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State | NY
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Zip | 13413
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Country | US
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Telephone | 315-733-2020
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Fax | 315-735-3628
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TUV0068761
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License Number State | NY
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