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General NPI Number Information
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NPI Number | 1972774107
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Entity Type | Organization
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Legal Business Name | PETER NESIN, OPTICIAN
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Dates
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Enumeration Date | 03/16/2008
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 158 NORTHPORT AVE
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City | BELFAST
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State | ME
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Zip | 04915-6060
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Country | US
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Telephone | 207-338-2440
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Fax | 207-338-2440
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Provider Business Mailing Address
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Address Line | 158 NORTHPORT AVE
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City | BELFAST
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State | ME
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Zip | 04915-6060
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Country | US
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Telephone | 207-338-2440
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Fax | 207-338-2440
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Authorized Official
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Title or Position | OWNER
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Name | MR. PETER NESIN
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Credential |
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Telephone | 207-338-2440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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