Provider Demographics
NPI:1760285928
Name:ALLAIRE, SEAN CHRISTOPHER (AZLOD)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:CHRISTOPHER
Last Name:ALLAIRE
Suffix:
Gender:
Credentials:AZLOD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 W REEVES AVE
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-6710
Mailing Address - Country:US
Mailing Address - Phone:480-452-3992
Mailing Address - Fax:
Practice Address - Street 1:21055 E RITTENHOUSE RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-4477
Practice Address - Country:US
Practice Address - Phone:480-457-1958
Practice Address - Fax:480-457-1960
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLDO-002439156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician