Provider Demographics
NPI:1962526392
Name:CIANO, JEREMY (OD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:
Last Name:CIANO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 MUSTANG CHASE DR
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8185
Mailing Address - Country:US
Mailing Address - Phone:317-730-1400
Mailing Address - Fax:317-844-7795
Practice Address - Street 1:14250 CLAY TERRACE BLVD
Practice Address - Street 2:#160
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-3632
Practice Address - Country:US
Practice Address - Phone:317-844-2020
Practice Address - Fax:317-730-1400
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003155A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist