Provider Demographics
NPI:1497803035
Name:DOWNING, STEPHEN CHARLES (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:CHARLES
Last Name:DOWNING
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 1:105 SOUTHWEST WAY
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-1208
Mailing Address - Country:US
Mailing Address - Phone:315-487-2035
Mailing Address - Fax:
Practice Address - Street 1:104 KASSON RD
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2248
Practice Address - Country:US
Practice Address - Phone:315-487-0327
Practice Address - Fax:315-487-4425
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4074156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician