Kelly Chichester

Individual provider Active NPI Optician · Perry, NY

NPI 1063919397 · NPPES record last updated Apr 12, 2018

Key facts

NPI
1063919397
Entity type
Individual (NPI type 1)
Primary specialty
Optician 156FX1800X
License
008707-1 (NY)
Practice address
1 Parker LN
Perry, NY 14530-9703
Phone
(585) 237-2064
Fax
(585) 237-2073
NPI assigned
Apr 12, 2018
Sex
Female
Sole proprietor
No

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
008707-1NYMDOptician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 008707-1 NY Yes

Addresses

Primary practice location

1 Parker LN
Perry, NY 14530-9703

Mailing address

2469 State Route 19 N
Warsaw, NY 14569-9336
Phone (585) 786-8505

Other providers in Perry, NY

All providers in Perry, NY · Optician in New York

Sources for this page

Verify at the official NPI Registry.