Provider Demographics
NPI:1194386409
Name:EINOWSKI, JEREMY THOMAS (DOCTOR OF OPTOMETRY)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:THOMAS
Last Name:EINOWSKI
Suffix:
Gender:M
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-7741
Mailing Address - Country:US
Mailing Address - Phone:775-575-1966
Mailing Address - Fax:
Practice Address - Street 1:198 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-7741
Practice Address - Country:US
Practice Address - Phone:775-575-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist