| Doctor Name: | MRS. DAWN ELLEN TITUS |
| NPI Number: | 1770717332 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPO |
| License Number: | 008987 |
| Business Practice Address: | 89 Montcalm St Ticonderoga, NY - 128831385 |
| Business Phone Number: | 5185854000 |
| Business Fax Number: | 5185855286 |
| Mailing Address: | 89 Montcalm Street, TICONDEROGA |
| State: | NY |
| Postal Code: | 128834004 |
| Phone Number: | 5185854000 |
| Fax Number: | 5185855286 |
| NPI Enumeration Date: | 05/12/2009 |
| NPI Last Update Date: | 05/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 008987 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |