| NPI | 1811667280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CEREO General Manager 315-567-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2021-09-16 |