Kevin B Wynne OD PLLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

002722 Issued in NY

Legal business name

KEVIN B WYNNE OD PLLC

Practice address

56 State St
Pittsford, NY 14534-2344

Phone

(585) 381-4640

NPI assigned

Mar 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Elizabeth Wynne

Title

Office Manager

Phone

(585) 381-4640

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Kevin B Wynne OD PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kevin B Wynne OD PLLC

  • Durable Medical Equipment & Medical Supplies
  • Pittsford, NY
  • NPI 1386818813
  NPD tax ID
• Kevin B Wynne OD PLLC

  • Eyewear Supplier
  • Pittsford, NY
  • NPI 1922277938
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin Bradley Wynne, OD

  • Optometrist
  • Pittsford, NY
  • NPI 1598752784
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1114197431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 STATE ST",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145342344",
            "telephone_number": "585-381-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 STATE ST",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145342344",
            "telephone_number": "585-381-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN B WYNNE OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "WYNNE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "585-381-4640",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "002722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "14929A",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katylin Kelly, MA, CCC-SLP
• Aimee Kelsey, LPN
• Valerie Kenyon
• Howard Kessler, D.O.
• James David Kestenbaum, PH.D.
• Kevin B Wynne OD PLLC
• Kevin B Wynne OD PLLC
• Anteres Kil
• Alexandra Kiley, DPT
• Chung Hoon Kim, MD

• Eyewear Supplier in Pittsford, NY
• Providers in Pittsford, NY by specialty
• Eyewear Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.