Provider Demographics
NPI:1861687402
Name:DR CLAFFIE AND ASSOCIATES
Entity Type:Organization
Organization Name:DR CLAFFIE AND ASSOCIATES
Other - Org Name:FAMILY EYE CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-360-0113
Mailing Address - Street 1:402 PREMIUM OUTLETS DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OH
Mailing Address - Zip Code:45050-1832
Mailing Address - Country:US
Mailing Address - Phone:513-360-0113
Mailing Address - Fax:
Practice Address - Street 1:402 PREMIUM OUTLETS DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OH
Practice Address - Zip Code:45050-1832
Practice Address - Country:US
Practice Address - Phone:513-360-0113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5832152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9390111OtherMEDICARE PTAN, GROUP
OH9390111OtherMEDICARE PTAN, GROUP