Mackenzie Bourdon
Technician/Technologist, Optician in Liverpool, NY. Individual provider (NPI-1).
NPI number1013735752
StatusActive
Last updated in NPPESDec 19, 2024
Details
- NPI
- 1013735752
- Entity type
- Individual (NPI-1)
- Name
- Mackenzie Bourdon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 1, 2024
- Certification date
- Dec 19, 2024
- Last updated
- Dec 19, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 010586-01 | NY | Yes |
Practice location
8770 Dell Center DrLiverpool, NY 13090-8700
Phone 315-622-9260 · Fax 315-652-5320
Mailing address
8770 Dell Center DrLiverpool, NY 13090-8700
Phone 315-622-9260 · Fax 315-652-5320
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Optician providers in Liverpool, NY
- Steven Calvin CummingsNPI 1578381216
- Amy DavisNPI 1194515619
- Gail Jewell HinmanNPI 1821816307
- Karen RidgewayNPI 1215755673
- Sharon E Ziegler, OPTICIANNPI 1588170252
All 6 Optician providers in Liverpool · All 1,360 providers in Liverpool
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