=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851584387
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CRAIG ALLEN CERNY O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2007
-----------------------------------------------------
Last Update Date | 11/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 652 GREAT NORTHERN MALL
-----------------------------------------------------
City | NORTH OLMSTED
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44070-3306
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-734-4896
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7305 BROADVIEW RD SUITE F
-----------------------------------------------------
City | SEVEN HILLS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-642-7373
-----------------------------------------------------
Fax | 216-642-7383
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 5706
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------