| NPI | 1699155549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA FULMER Owner 315-439-7518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY 007991) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NY 007991) |
| 152WP0200X Optometrist, Pediatrics (Licence: NY 007991) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: NY 007991) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-09-16 |