Provider Demographics
NPI:1750332839
Name:REDMAN, ELIZABETH JS (OD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JS
Last Name:REDMAN
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:2921 ERIE BLVD E
Mailing Address - Street 2:C/O EMPIRE VISION CENTER, INC
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1430
Mailing Address - Country:US
Mailing Address - Phone:315-445-7465
Mailing Address - Fax:315-445-7675
Practice Address - Street 1:75 WASHINGTON ST STE 3
Practice Address - Street 2:MASS OPTOMETRIC ASSOCIATES, P.C.
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1887
Practice Address - Country:US
Practice Address - Phone:781-826-5117
Practice Address - Fax:781-826-0954
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4541152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW17616Medicare ID - Type Unspecified
V07620Medicare UPIN