Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blaine Eye Clinic Optometrists, PA

Organization Optometrist · NPI 1043363401

Blaine Eye Clinic Optometrists, PA is an Optometrist in Blaine, Minnesota. Licensed in Minnesota. Registered with an NPI since 2007.

Licensed in
MN
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12170 Aberdeen St NE
Blaine, MN 55449-4716
Phone: (763) 757-7000
Fax: (763) 757-3328
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X (MN)
Optometrist Taxonomy 152W00000X (MN)

Record details

NPI number1043363401
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lynn Sulerud — Owner · (763) 757-7000
Other names Blaine Eye Clinic
NPI enumeratedJanuary 19, 2007
Last updated in NPPESFebruary 15, 2011
Mailing address12170 Aberdeen St Ne, Blaine, MN 55449-4716

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