Provider Demographics
NPI:1407830227
Name:SIENKO, MAUREEN ANN (OD)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:SIENKO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 CHURCH STREET
Mailing Address - Street 2:SUITE #1
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866
Mailing Address - Country:US
Mailing Address - Phone:518-587-8400
Mailing Address - Fax:518-587-4155
Practice Address - Street 1:254 CHURCH STREET
Practice Address - Street 2:SUITE #1
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866
Practice Address - Country:US
Practice Address - Phone:518-587-8400
Practice Address - Fax:518-587-4155
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0046041152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T26716Medicare UPIN
NYDD1556Medicare PIN