Provider Demographics
NPI:1275315939
Name:WERNICK OPTOMETRY PLLC
Entity Type:Organization
Organization Name:WERNICK OPTOMETRY PLLC
Other - Org Name:WERNICK OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAT
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:WERNICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-819-3928
Mailing Address - Street 1:91 DIAMOND ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-7452
Mailing Address - Country:US
Mailing Address - Phone:405-819-3928
Mailing Address - Fax:
Practice Address - Street 1:943 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5107
Practice Address - Country:US
Practice Address - Phone:405-819-3928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty