Provider Demographics
NPI:1164894135
Name:JULIANN KANDRA, OD, PC
Entity Type:Organization
Organization Name:JULIANN KANDRA, OD, PC
Other - Org Name:FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-818-8732
Mailing Address - Street 1:323 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1514
Mailing Address - Country:US
Mailing Address - Phone:207-284-6791
Mailing Address - Fax:207-283-0309
Practice Address - Street 1:323 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1514
Practice Address - Country:US
Practice Address - Phone:207-284-6791
Practice Address - Fax:207-283-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT967152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty