| |
2730 Route, 12b, Hamilton, NY 13346-2113 | |
(315) 824-3453 | |
(315) 824-4301 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 2730 Route, Hamilton, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205005931 | NPI | - | NPPES |
00600977 | Medicaid | NY | |
56480A | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | 3797-1 (New York) | Secondary |
Mailing Address | Practice Location Address |
---|---|
2901 Court Street, Syracuse, NY 13208-3217 Ph: (315) 455-8933 | 2730 Route, 12b, Hamilton, NY 13346-2113 Ph: (315) 824-3453 |