| Organization Name: | SOUTHERN TIER OPTOMETRIC CENTER, INC. |
| NPI Number: | 1164424875 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SAM ROSENSWIE (CORPORATE BUSINESS MANAGER) |
| Mailing Address: | 168 N Union St Olean |
| State: | NY US |
| Postal Code: | 147602735 |
| Phone Number: | 7163729464 |
| Fax Number: | |
| NPI Enumeration Date: | 08/12/2005 |
| NPI Last Update Date: | 04/18/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | C003108-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |