Vanessa J. Azzoto, OPTICIAN

Individual provider Active NPI Optician · Cicero, NY

NPI 1023045911 · NPPES record last updated Oct 16, 2009

Key facts

NPI
1023045911
Entity type
Individual (NPI type 1)
Primary specialty
Optician 156FX1800X
License
008383-1 (NY)
Practice address
7903 Brewerton Rd
West Marine Plaza
Cicero, NY 13039-9531
Phone
(315) 699-1700
Fax
(315) 699-1707
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
008383-1NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Leener Corp. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 008383-1 NY Yes

Addresses

Primary practice location

7903 Brewerton Rd
West Marine Plaza
Cicero, NY 13039-9531

Mailing address

8811 Wedgefield LN
Cicero, NY 13039-9775
Phone (315) 698-0576

Other providers in Cicero, NY

All providers in Cicero, NY · Optician in New York

Sources for this page

Verify at the official NPI Registry.