=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891977724
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARRITY OPTICAL INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/03/2007
-----------------------------------------------------
Last Update Date | 02/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6913 ERIE RD
-----------------------------------------------------
City | DERBY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14047-9689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-947-9992
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6913 ERIE RD
-----------------------------------------------------
City | DERBY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14047-9689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-947-9992
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JAMES G HARRITY
-----------------------------------------------------
Credential | OPT
-----------------------------------------------------
Telephone | 716-947-9992
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------