Provider Demographics
NPI:1811139843
Name:HAWES, SHEILA MARIE (OPTICIAN/CL PRACTITI)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:MARIE
Last Name:HAWES
Suffix:
Gender:F
Credentials:OPTICIAN/CL PRACTITI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-1052
Mailing Address - Country:US
Mailing Address - Phone:315-764-1878
Mailing Address - Fax:315-764-0591
Practice Address - Street 1:159 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-1052
Practice Address - Country:US
Practice Address - Phone:315-764-1878
Practice Address - Fax:315-764-0591
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5050156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician