Provider Demographics
NPI:1922198969
Name:WEISS, SAVEDOFF & CICCONE, DOCTORS OF OPTOMETRY, P.C.
Entity Type:Organization
Organization Name:WEISS, SAVEDOFF & CICCONE, DOCTORS OF OPTOMETRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNET
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAVEDOFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:315-472-4594
Mailing Address - Street 1:60 PRESIDENTIAL PLZ
Mailing Address - Street 2:MADISON TOWER
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-2292
Mailing Address - Country:US
Mailing Address - Phone:315-472-4594
Mailing Address - Fax:315-422-3068
Practice Address - Street 1:60 PRESIDENTIAL PLZ
Practice Address - Street 2:MADISON TOWER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-2292
Practice Address - Country:US
Practice Address - Phone:315-472-4594
Practice Address - Fax:315-422-3068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV3788-1152W00000X
NYTUV005682-1152W00000X
NYT004912-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY31552AOtherGROUP PIN NUMBER
NY31552AOtherGROUP PIN NUMBER
NY0223410001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT