Provider Demographics
NPI:1063415867
Name:EPSTEIN, PERRY (LDO)
Entity type:Individual
Prefix:MR
First Name:PERRY
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:SOLON
Other - Middle Name:VALLEY
Other - Last Name:OPTICAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:34050 SOLON RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2664
Mailing Address - Country:US
Mailing Address - Phone:440-248-8535
Mailing Address - Fax:
Practice Address - Street 1:34050 SOLON RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2664
Practice Address - Country:US
Practice Address - Phone:440-248-8535
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH26 SC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01368100001Medicare ID - Type Unspecified