Provider Demographics
NPI:1922002641
Name:PERZY, F. TODD (OD)
Entity Type:Individual
Prefix:DR
First Name:F.
Middle Name:TODD
Last Name:PERZY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4014 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-3033
Mailing Address - Country:US
Mailing Address - Phone:330-225-1254
Mailing Address - Fax:330-225-2033
Practice Address - Street 1:4014 CENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3033
Practice Address - Country:US
Practice Address - Phone:330-225-1254
Practice Address - Fax:330-225-2033
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5407152W00000X, 152WC0802X, 152WP0200X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH300190443026OtherCARESOURCE
OHOH5407OtherEYEMED
OH2433209Medicaid
OH000000317105OtherBLUE CROSS
OHP00059627OtherRAILROAD MEDICARE
OH2433209Medicaid
OH000000317105OtherBLUE CROSS