| NPI | 1659779338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JUDE JOBA Od 716-947-2462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 007272) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NY 07272) |
| Enumeration Date | 2014-12-12 |
| Last Update Date | 2025-09-17 |