| NPI | 1336264548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN VAN WAGNER Patient Service Representative 845-338-3302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: NY 4882) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-01-17 |