| |
1440 Central Ave Ste E-2, Colonie, NY 12205-5118 | |
(518) 489-8575 | |
(518) 489-8578 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1440 Central Ave Ste E-2, Colonie, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689640112 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
156F00000X | Technician/technologist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
19100 Ridgewood Pkwy Bldg 17th, San Antonio, TX 78259-1834 Ph: (726) 444-4078 | 1440 Central Ave Ste E-2, Colonie, NY 12205-5118 Ph: (518) 489-8575 |