Provider Demographics
NPI:1790176394
Name:OSSIP OPTOMETRY, PC
Entity Type:Organization
Organization Name:OSSIP OPTOMETRY, PC
Other - Org Name:OSSIP FOCUS EYENOBLESVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE AND INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DABELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-254-6480
Mailing Address - Street 1:9795 CROSSPOINT BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3354
Mailing Address - Country:US
Mailing Address - Phone:317-254-6480
Mailing Address - Fax:317-259-8609
Practice Address - Street 1:14540 PRAIRIE LAKES BLVD N
Practice Address - Street 2:STE 100
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4366
Practice Address - Country:US
Practice Address - Phone:317-770-8555
Practice Address - Fax:317-770-8558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01048750152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty