National Provider Identifier

Martin D Ennulat

Martin D Ennulat is listed in the NPPES registry with a primary specialty of Optician in Corning, NY and a listed phone number of (607) 962-0386.

NPI 1467588517Corning, NYOptician

Profile Overview

NPI
1467588517
Provider Type
Individual
Primary Specialty
Optician
Enumeration Date
February 25, 2007
Last Updated
July 08, 2007

Practice Location

  • 115 E 1St St
  • Corning, NY 14830-2710

Phone: (607) 962-0386

Mailing Address

  • 2936 Powderhouse RD
  • Corning, NY 14830-9629

Specialties

  • Optician (156FX1800X)
Full Record
NPI
1467588517
Entity Type
Individual
Last Name
Ennulat
First Name
Martin
Middle Name
D
Name Prefix
Mr.
Mailing Street Address
2936 Powderhouse RD
Mailing City
Corning
Mailing State
NY
Mailing ZIP Code
14830-9629
Mailing Country
US
Mailing Phone
(607) 936-0141
Practice Street Address
115 E 1St St
Practice City
Corning
Practice State
NY
Practice ZIP Code
14830-2710
Practice Country
US
Practice Phone
(607) 962-0386
Enumeration Date
February 25, 2007
Last Updated
July 08, 2007
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Optician (156FX1800X)