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General NPI Number Information
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NPI Number | 1881782704
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Entity Type | Organization
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Legal Business Name | KENS'EYEWEAR INC.
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 12/28/2007
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Provider Practice Location Address
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Address Line | 41 COURT STREET
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City | WESTFIELD
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State | MA
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Zip | 01085
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Country | US
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Telephone | 413-562-0763
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Fax |
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Provider Business Mailing Address
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Address Line | 41 COURT STREET
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City | WESTFIELD
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State | MA
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Zip | 01085
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Country | US
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Telephone | 413-562-0763
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. KENNETH ALFRED FORNI
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Credential |
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Telephone | 413-733-0867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | MA1524
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | MA1524
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License Number State | MA
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