Provider Demographics
NPI:1306178207
Name:DAVID J. BRAUN, O.D., P.C.
Entity Type:Organization
Organization Name:DAVID J. BRAUN, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:315-214-5858
Mailing Address - Street 1:120 JULIAN PL
Mailing Address - Street 2:ORIGINAL EYEWEAR
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3460
Mailing Address - Country:US
Mailing Address - Phone:315-214-5858
Mailing Address - Fax:315-218-5966
Practice Address - Street 1:120 JULIAN PL
Practice Address - Street 2:ORIGINAL EYEWEAR
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-3460
Practice Address - Country:US
Practice Address - Phone:315-214-5858
Practice Address - Fax:315-218-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006089302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization