Provider Demographics
NPI:1457662777
Name:HELLER, ARTHUR J (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:J
Last Name:HELLER
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 11
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:NY
Mailing Address - Zip Code:12822-0011
Mailing Address - Country:US
Mailing Address - Phone:518-654-7066
Mailing Address - Fax:518-654-7066
Practice Address - Street 1:92 MAIN ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:NY
Practice Address - Zip Code:12822-1009
Practice Address - Country:US
Practice Address - Phone:518-654-7066
Practice Address - Fax:518-654-7066
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007664-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier