Basic Information
| Provider Information | |||||||||
| NPI: | 1851584387 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CERNY | ||||||||
| FirstName: | CRAIG | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7107 VIRGINIA AVE | ||||||||
| Address2: | |||||||||
| City: | PARMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441292640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4405031828 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 652 GREAT NORTHERN MALL | ||||||||
| Address2: | |||||||||
| City: | NORTH OLMSTED | ||||||||
| State: | OH | ||||||||
| PostalCode: | 440703306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4407344896 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2007 | ||||||||
| LastUpdateDate: | 08/17/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 5706 | OH | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.