Blank, Frederick Donald

Blank, Frederick Donald is an sole proprietor health care provider with primary practice located at 2512 Clark Ave , Cleveland OH 44109-1111. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Blank, Frederick Donald can be contacted via phone (216) 241-2040.

Contact Information

Primary practice address
2512 Clark Ave Cleveland OH 44109-1111
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X #2856 Ohio

Profile Details

NPI number 1508905241
LBN Legal business name Blank, Frederick Donald
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 6th, 2007
Last updated Jul 8th, 2007 - about 17 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 1508905241 NPPES
Ohio MEDICAID 0248084

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