MEDICARE: DR STEIN OPTICAL CLINIC INC

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
1	152W00000X	Optometrist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598836975
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR STEIN OPTICAL CLINIC INC

Provider Business Mailing Address
First Line	:	1249 MONROE ST NW
Second Line	:
City	:	NEW PHILADELPHIA
State	:	OH
Zip	:	44663-4139
Country	:	US
Telephone Number	:	330-364-2512
Fax Number	:	330-364-2078

Provider Business Practice Location Address
First Line	:	1249 MONROE ST NW
Second Line	:
City	:	NEW PHILADELPHIA
State	:	OH
Zip	:	44663-4139
Country	:	US
Telephone Number	:	330-364-2512
Fax Number	:	330-364-2078

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEVEN A MANELLO
Credential	:	OD
Telephone Number	:	330-364-2512

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	10/13/2011

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Directions to “DR STEIN OPTICAL CLINIC INC ” Practice Location

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