Susan Licata Durham in Raleigh - Sports Vision
Susan Licata Durham - NPI 1023043163
Susan Licata Durham is a Sports Vision in Raleigh, North Carolina. Susan Licata Durham practices all healthcare services and medical treatments related to Sports Vision. The NPI Number for Susan Licata Durham is 1023043163. The last update date is 2011-09-29.
Susan Licata Durham's current location address is 10207 Cerny St, Raleigh, North Carolina. You can contact this provider via phone number 9193612299 and fax number 9193610055. The mailing address for Susan Licata Durham is 10207 Cerny St, Raleigh, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan Licata Durham |
|---|---|
| Address | 10207 Cerny St, Raleigh, North Carolina |
| Phone Number | 9193612299 |
| Fax Number | 9193610055 |
| Sole Proprietor | N |
| Credentials | OD |
NPI Number Detail
| NPI Number | 1023043163 |
|---|---|
| Provider Enumeration Date | 2006-07-11 |
| Last Updated Date | 2011-09-29 |
Provider Mailing Address Detail
| Address | 10207 Cerny St |
|---|---|
| City | Raleigh |
| State | North Carolina (NC) |
| Post Code | 276177878 |
| Phone Number | 9193612299 |
| Fax Number | 9193610055 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Vision |
|---|---|
| Taxonomy | 152Ws0006X |
| Licence No | 1335 |
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Definition: An optometrist who offers services designed to care for unique vision care needs of athletes, which may include one of more of the following services: corrective vision care unique to a specific sporting environment; protective eyewear for the preven |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 410036278 | NC | RAILROAD MEDICARE | |
| 1223620002 | NC | PALMETTO DMERC |
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What is the unique 10-digit identifier code issued to Susan Licata Durham by the Centers for Medicare & Medicaid Services?
The Susan Licata Durham has been assigned the NPI (National Provider Identifier) 1023043163 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Susan Licata Durham's facilities are geographically located?
The facilities of Susan Licata Durham are physically situated at the following location: 10207 Cerny St, Raleigh, NC, 276177878.
What is Susan Licata Durham's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Susan Licata Durham is Sports Vision, and the taxonomy code that classifies this field of practice is 152Ws0006X.
On what date did the Centers for Medicare & Medicaid Services issue the 1023043163 to Susan Licata Durham?
The Susan Licata Durham received its 1023043163 assignment from the Centers for Medicare & Medicaid Services on 2006-07-11.
When was the information related to Susan Licata Durham most recently updated or refreshed?
The details pertaining to the Susan Licata Durham, including its address, specialty, and other relevant information, were last updated or refreshed on 2011-09-29.
NPI Number: 1891797999
Address: Po Box 4048, Houston, TX