Provider Demographics
NPI:1497704068
Name:SIRGANY, BRIAN J (OD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:SIRGANY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:992 STATE ROUTE 13
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-3528
Mailing Address - Country:US
Mailing Address - Phone:607-749-2020
Mailing Address - Fax:
Practice Address - Street 1:992 STATE ROUTE 13
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045
Practice Address - Country:US
Practice Address - Phone:607-749-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006874152W00000X
PAOEG000299152W00000X
NJ27TO00119200152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ057488OtherPIN
U87814Medicare UPIN