| NPI | 1083303903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE DETORE COO 518-744-9911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-07-02 |