Berenson, Thomas Howard

Berenson, Thomas Howard is an individual health care provider with primary practice located at 3300 S Aspen Ave Suite D, Broken Arrow OK 74012-7501. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Berenson, Thomas Howard can be contacted via phone (918) 451-2020.

Contact Information

Primary practice address
3300 S Aspen Ave Suite D Broken Arrow OK 74012-7501
Fax: (918) 449-9086
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 795 Oklahoma

Profile Details

NPI number 1942280896
LBN Legal business name Berenson, Thomas Howard
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated May 6th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942280896 NPPES
Oklahoma MEDICAID 100765420A

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