Provider Demographics
NPI:1245379924
Name:BYRNES, STEPHEN P (O D)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:P
Last Name:BYRNES
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 579
Mailing Address - Street 2:80 NASHUA ROAD
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-0579
Mailing Address - Country:US
Mailing Address - Phone:603-434-4449
Mailing Address - Fax:603-432-6059
Practice Address - Street 1:80 NASHUA ROAD
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053
Practice Address - Country:US
Practice Address - Phone:603-434-4449
Practice Address - Fax:603-432-6059
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH334152W00000X
MA2643152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2284OtherIDENTIFICATION NUMBER
T87470Medicare UPIN