Provider Demographics
NPI:1053359463
Name:PRINSTEIN, ANDREA C (OD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:C
Last Name:PRINSTEIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5577 MONROE ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2549
Mailing Address - Country:US
Mailing Address - Phone:419-472-2020
Mailing Address - Fax:419-885-7876
Practice Address - Street 1:5577 MONROE ST
Practice Address - Street 2:SUITE J
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2549
Practice Address - Country:US
Practice Address - Phone:419-472-2020
Practice Address - Fax:419-885-7876
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003586152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
OH4166T602152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Not Answered152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Not Answered152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Not Answered152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Not Answered152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Not Answered152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision