National Provider Identifier Database

RUSSELL J AVERY SR, LICENSED OPTICIAN – NPI #1467598334
Optician


Contact Information

RUSSELL J AVERY SR, LICENSED OPTICIAN
KNAUF OPTICAL
235 VESTAL AVE.
ENDICOTT, NY13760
Phone: 607-748-0765
Fax: 607-748-0765
Website:
Specialty Taxonomy Code
* Optician 156FX1800X

* Indicates primary specialty

NPI Profile & details for RUSSELL J AVERY SR

NPI Number 1467598334
Credentials LICENSED OPTICIAN
Entity Individual
Enumeration date 01/29/2007
Last updated 07/09/2007 - About 19 years ago
Sole proprietor1 Yes
Identifiers
  • NY License #: 6965
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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