Provider Demographics
NPI:1215013016
Name:BALCIUNAS, LIDIJA MARIJA (OD)
Entity type:Individual
Prefix:
First Name:LIDIJA
Middle Name:MARIJA
Last Name:BALCIUNAS
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1909 E 101ST ST
Mailing Address - Street 2:CLEVELAND SIGHT CENTER
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106
Mailing Address - Country:US
Mailing Address - Phone:216-791-8118
Mailing Address - Fax:216-791-1101
Practice Address - Street 1:1909 E 101ST ST
Practice Address - Street 2:CLEVELAND SIGHT CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106
Practice Address - Country:US
Practice Address - Phone:216-791-8118
Practice Address - Fax:216-791-1101
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3915152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BA0656983Medicare ID - Type Unspecified
U03010Medicare UPIN