Provider Demographics
NPI:1700806973
Name:BRAUN, DAVID J (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:BRAUN
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 1:120 JULIAN PL
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3460
Mailing Address - Country:US
Mailing Address - Phone:315-214-5858
Mailing Address - Fax:315-218-5966
Practice Address - Street 1:120 JULIAN PL
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-3460
Practice Address - Country:US
Practice Address - Phone:315-214-5858
Practice Address - Fax:315-218-5966
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT006089152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000131627OtherBCBS PROVIDER ID
NY9681599OtherMVP PROVIDER ID
NYU79915Medicare UPIN
NYCC5316Medicare ID - Type UnspecifiedMEDICARE #