Organization
M B KAYANI PHYSICIAN PC
Active
Parent organization
M B KAYANI PHYSICIAN PC
Other names
Watertown Eye Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
M B KAYANI PHYSICIAN PC
Authorized official
NOAMAN SANNI MD (OWNER)
(315) 788-6070
Entity
Organization
Contact information
Practice address
12 MAIN ST, POTSDAM, NY 13676-2007
(315) 261-4287
(315) 261-4319
Mailing address
1815 STATE ST, WATERTOWN, NY 13601-9406
(315) 788-6070
(315) 788-1950
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03424311
—
NY
Enumeration date
03/21/2013
Last updated
09/12/2013
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