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NPI Code Detail

MEDICARE: DR. CHRISTOPHER SHIOMOS O.D.

MEDICARE: DR. CHRISTOPHER SHIOMOS O.D.
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
1152W00000XOptometristTUV005571NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TUV0055711OTHERNYOD LICENSE

General Provider Information

NPI Number : 1306947411
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER SHIOMOS O.D.
Provider Business Mailing Address
First Line : 5000 BRITTONFIELD PKWY
Second Line : SUITE A-102
City : EAST SYRACUSE
State : NY
Zip : 13057-9226
Country : US
Telephone Number : 315-432-0555
Fax Number : 315-463-6219
Provider Business Practice Location Address
First Line : 5000 BRITTONFIELD PKWY
Second Line : SUITE A-102
City : EAST SYRACUSE
State : NY
Zip : 13057-9226
Country : US
Telephone Number : 315-432-0555
Fax Number : 315-463-6219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 01/09/2012

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