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NPI Code Detail

MEDICARE: SAMUEL A. SEBASTIAN & GENE HRYCAK DBA OPTICAL VISION OF YOUNGSTOWN

MEDICARE: SAMUEL A. SEBASTIAN & GENE HRYCAK DBA OPTICAL VISION OF YOUNGSTOWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear SupplierSC 198OH
2156FX1800XOptician

General Provider Information

NPI Number : 1003942434
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAMUEL A. SEBASTIAN & GENE HRYCAK DBA OPTICAL VISION OF YOUNGSTOWN
Provider Business Mailing Address
First Line : 2959 CANFIELD RD
Second Line : SUITE #1
City : YOUNGSTOWN
State : OH
Zip : 44511-2800
Country : US
Telephone Number : 330-792-7045
Fax Number : 330-792-0038
Provider Business Practice Location Address
First Line : 2959 CANFIELD RD
Second Line : SUITE #1
City : YOUNGSTOWN
State : OH
Zip : 44511-2800
Country : US
Telephone Number : 330-792-7045
Fax Number : 330-792-0038
Authorized Official
Title or Position : PARTNER
Name : MR. SAMUEL A SEBASTIAN
Credential : OPTICIAN
Telephone Number : 330-792-7045
Provider Enumeration Date : 02/27/2007
Last Update Date : 06/17/2008

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