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General NPI Number Information
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NPI Number | 1558290692
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Entity Type | Organization
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Legal Business Name | TELEOPTOMETRIC SERVICE, P.C.
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Dates
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Enumeration Date | 05/15/2026
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Last Update Date | 05/15/2026
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Provider Practice Location Address
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Address Line | 8201 OLD CARRIAGE CT STE 307
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City | SHAKOPEE
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State | MN
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Zip | 55379-3154
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Country | US
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Telephone | 380-223-3412
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Fax |
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Provider Business Mailing Address
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Address Line | 5 DAKOTA DR STE 307
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1106
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Country | US
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Telephone | 380-223-3412
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | SUSAN L CHRISTOPHER-BRAND
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Credential |
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Telephone | 703-314-8795
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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 |
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License Number State |
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