Burgenstock, Breanna Lynn

Burgenstock, Breanna Lynn is an individual health care provider with primary practice located at 20823 Nys Rt 3 , Watertown NY 13601-5577. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Burgenstock, Breanna Lynn can be contacted via phone (315) 788-1570.

Contact Information

Primary practice address
20823 Nys Rt 3 Watertown NY 13601-5577
Phone: (315) 788-1570
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 8463-1 New York

Profile Details

NPI number 1982111803
LBN Legal business name Burgenstock, Breanna Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2017
Last updated Jun 16th, 2018 - about 7 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 1982111803 NPPES
New York MEDICAID 207069530

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