| |
25 Hospital Dr, Massena, NY 13662-1009 | |
(315) 705-6508 | |
(315) 705-6511 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 25 Hospital Dr, Massena, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043552854 | NPI | - | NPPES |
03424311 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1815 State St, Watertown, NY 13601-9407 Ph: (315) 788-6070 | 25 Hospital Dr, Massena, NY 13662-1009 Ph: (315) 705-6508 |