Provider Demographics
NPI:1558680306
Name:ORR, JAMES S (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:S
Last Name:ORR
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1418
Mailing Address - Country:US
Mailing Address - Phone:516-442-1570
Mailing Address - Fax:516-442-1573
Practice Address - Street 1:1300 GRAND AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1418
Practice Address - Country:US
Practice Address - Phone:516-442-1570
Practice Address - Fax:516-442-1573
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009105156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician