| NPI | 1871663567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY M SULLIVAN-DEC Administrator 315-458-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2014-01-29 |