Provider Demographics
NPI:1770892341
Name:CLTOPERATIONS, LLC
Entity type:Organization
Organization Name:CLTOPERATIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:LEEANN
Authorized Official - Last Name:TUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:315-455-9355
Mailing Address - Street 1:2605 BREWERTON ROAD
Mailing Address - Street 2:
Mailing Address - City:MATTYDALE
Mailing Address - State:NY
Mailing Address - Zip Code:13211
Mailing Address - Country:US
Mailing Address - Phone:315-455-9355
Mailing Address - Fax:
Practice Address - Street 1:323 COUNTY ROUTE 37
Practice Address - Street 2:
Practice Address - City:CENTRAL SQUARE
Practice Address - State:NY
Practice Address - Zip Code:13036-2142
Practice Address - Country:US
Practice Address - Phone:315-455-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012445174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty