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General NPI Number Information
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NPI Number | 1992193916
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Entity Type | Organization
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Legal Business Name | KANE & DALESSANDRO LLC
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 8505 TANGLEWOOD SQ
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City | CHAGRIN FALLS
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State | OH
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Zip | 44023-6434
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Country | US
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Telephone | 440-221-7241
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Fax |
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Provider Business Mailing Address
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Address Line | 6507 DERBY DR
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City | MAYFIELD VILLAGE
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State | OH
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Zip | 44143-3420
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Country | US
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Telephone | 440-221-2741
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN J KANE
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Credential | O.D.
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Telephone | 440-221-7241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4751
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License Number State | OH
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