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General NPI Number Information
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NPI Number | 1750463006
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Entity Type | Organization
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Legal Business Name | EYE DESIGNS UNLIMITED OPTOMETRY PC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 289 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13501-3804
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Country | US
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Telephone | 315-732-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 289 GENESEE ST
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City | UTICA
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State | NY
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Zip | 13501-3804
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Country | US
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Telephone | 315-732-1511
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL KIRKPATRICK
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Credential | OD
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Telephone | 315-732-1151
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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 | TUV0051531
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License Number State | NY
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