Clemens, Dale S
Clemens, Dale S is an individual health care provider with primary practice located at 824 Franklin Park Dr , East Syracuse NY 13057-1614. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Contact Lens Fitter, Eye and Vision Services Providers / Optician. Eye and Vision Services Providers / Optician is his primary health care specialty. Clemens, Dale S can be contacted via phone (315) 446-1288.Contact Information
Primary practice address
824 Franklin Park Dr
East Syracuse NY 13057-1614
Phone: (315) 446-1288
Fax: (315) 463-2210
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Contact Lens Fitter | 156FC0801X | C006828 | New York |
| Eye and Vision Services Providers / Optician | 156FX1800X | C006828 | New York |
Profile Details
| NPI number | 1659438455 |
|---|---|
| LBN Legal business name | Clemens, Dale S |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 2nd, 2007 |
| Last updated | Jun 27th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659438455 | NPPES |
| New York | Other | C006828 | OPHTHALMIC DISPENSING LIC |
| New York | Other | NY6828 | OPHTHALMIC DISPENSING LIC |
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