Provider Demographics
NPI:1093781213
Name:CLAFFIE, SEAN (OD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:CLAFFIE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 PREMIUM OUTLETS DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1832
Mailing Address - Country:US
Mailing Address - Phone:513-360-0113
Mailing Address - Fax:513-360-0133
Practice Address - Street 1:402 PREMIUM OUTLETS DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1832
Practice Address - Country:US
Practice Address - Phone:513-360-0113
Practice Address - Fax:513-360-0133
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC0003100152W00000X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4296971OtherPTAN
FL620328101Medicaid
OH4296971OtherPTAN
FL20798ZMedicare PIN