Individual
KEVIN BRADLEY WYNNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005374
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102002CS
PREFERRED CARE
NY
01
—
14929A
MEDICARE GROUP #
—
01
—
7100219
AETNA
NY
01
—
PO10005374
BLUE CHOICE
NY
Enumeration date
10/03/2005
Last updated
10/17/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up