Provider Demographics
NPI:1043343593
Name:TRINCA, BRUCE (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:TRINCA
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-1307
Mailing Address - Country:US
Mailing Address - Phone:607-687-1174
Mailing Address - Fax:607-687-1175
Practice Address - Street 1:58 NORTH AVE
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-1307
Practice Address - Country:US
Practice Address - Phone:607-687-1174
Practice Address - Fax:607-687-1175
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC3644156FC0801X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician