Facchin, John A

Facchin, John A is an sole proprietor health care provider with primary practice located at 111 Grand Avenue , Massapequa NY 11758. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Facchin, John A can be contacted via phone (516) 798-2635.

Contact Information

Primary practice address
111 Grand Avenue Massapequa NY 11758
Phone: (516) 798-2635
Fax: (516) 798-0896
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TUV0052761 New York
Eye and Vision Services Providers / Vision Therapy 152WV0400X TUV0052761 New York

Profile Details

NPI number 1659336055
LBN Legal business name Facchin, John A
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2006
Last updated Mar 20th, 2008 - 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 1659336055 NPPES
New York MEDICAID 01474419

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