Provider Demographics
NPI:1114218393
Name:SAFI OPTOMETRIST PC
Entity Type:Organization
Organization Name:SAFI OPTOMETRIST PC
Other - Org Name:MONDO OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONDO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:315-546-0393
Mailing Address - Street 1:1001 W FAYETTE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2856
Mailing Address - Country:US
Mailing Address - Phone:315-472-1488
Mailing Address - Fax:
Practice Address - Street 1:333 W WASHINGTON ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-6103
Practice Address - Country:US
Practice Address - Phone:315-410-2027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty