Organization Name: | KEVIN B WYNNE OD PLLC |
NPI Number: | 1386818813 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN BRADLEY WYNNE (OPTOMETRIST) |
Mailing Address: | 56 State St Pittsford |
State: | NY US |
Postal Code: | 145342344 |
Phone Number: | 5853814640 |
Fax Number: | |
NPI Enumeration Date: | 04/16/2008 |
NPI Last Update Date: | 04/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | TUV005374-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |