Provider Demographics
NPI:1629248554
Name:JEREMY CIANO, PC
Entity Type:Organization
Organization Name:JEREMY CIANO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDNET/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CIANO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-844-2020
Mailing Address - Street 1:14250 CLAY TERRACE BLVD
Mailing Address - Street 2:#160
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3632
Mailing Address - Country:US
Mailing Address - Phone:317-844-2020
Mailing Address - Fax:
Practice Address - Street 1:14250 CLAY TERRACE BLVD
Practice Address - Street 2:#160
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3632
Practice Address - Country:US
Practice Address - Phone:317-844-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003155A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty