Breanna Lynn Burgenstock
Technician/Technologist, Optician in Watertown, NY. Individual provider (NPI-1).
NPI number1982111803
StatusActive
Last updated in NPPESSep 29, 2026
Details
- NPI
- 1982111803
- Entity type
- Individual (NPI-1)
- Name
- Breanna Lynn Burgenstock
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 30, 2017
- Last updated
- Sep 29, 2026
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 | 8463-1 | NY | Yes |
Practice location
20823 Nys Rt 3Watertown, NY 13601-5577
Phone 315-788-1570
Mailing address
20823 Nys Rt 3Watertown, NY 13601-5577
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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.
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All 12 Optician providers in Watertown · All 1,646 providers in Watertown
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