Provider Demographics
NPI:1669548152
Name:PAYNOWSKI, JANICE (OD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:PAYNOWSKI
Suffix:
Gender:F
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:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-5880
Mailing Address - Country:US
Mailing Address - Phone:330-697-4748
Mailing Address - Fax:866-425-2239
Practice Address - Street 1:3265 W MARKET ST
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3337
Practice Address - Country:US
Practice Address - Phone:330-697-4748
Practice Address - Fax:866-425-2239
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3885152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHT48546Medicare UPIN