Provider Demographics
NPI:1316023039
Name:NESIN, PETER (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:NESIN
Suffix:
Gender:M
Credentials:OPTICIAN
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 476
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0476
Mailing Address - Country:US
Mailing Address - Phone:207-338-2440
Mailing Address - Fax:207-338-2440
Practice Address - Street 1:158 NORTHPORT AVE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6060
Practice Address - Country:US
Practice Address - Phone:207-338-2440
Practice Address - Fax:207-338-2440
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician