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1760668107 NPI number — BI COUNTY OPHTHALMOLOGY PC

NPI Number: 1760668107
Health Care Provider/Practitioner: BI COUNTY OPHTHALMOLOGY PC

Information about “1760668107” NPI (BI COUNTY OPHTHALMOLOGY PC) exists in 1760668107 in HTML format HTML  |  1760668107 in plain Text format TXT  |  1760668107 in PDF (Portable Document Format) PDF  |  1760668107 in an XML format XML  formats.

NPI Number : 1760668107 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1760668107",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BI COUNTY OPHTHALMOLOGY PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "28001 SCHOENHERR RD",
    "SecondLineMailingAddress": "SUITE 2",
    "MailingAddressCityName": "WARREN",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48088-4396",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "586-756-5060",
    "MailingAddressFaxNumber": "586-756-9783",
    "FirstLinePracticeLocationAddress": "28001 SCHOENHERR RD",
    "SecondLinePracticeLocationAddress": "SUITE 2",
    "PracticeLocationAddressCityName": "WARREN",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48088-4396",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "586-756-5060",
    "PracticeLocationAddressFaxNumber": "586-756-9783",
    "EnumerationDate": "01/16/2008",
    "LastUpdateDate": "01/29/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CARDELLIO",
    "AuthorizedOfficialFirstName": "JESSE",
    "AuthorizedOfficialMiddleName": "J",
    "AuthorizedOfficialTitle": "OWNER/ PRESIDENT",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DO",
    "AuthorizedOfficialTelephoneNumber": "586-756-5060",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332H00000X",
          "TaxonomyName": "Eyewear Supplier",
          "LicenseNumber": "005215",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207W00000X",
          "TaxonomyName": "Ophthalmology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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