Healthcare Provider Details

I. General information

NPI: 1043324775
Provider Name (Legal Business Name): CONSUMER OPTICAL CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 08/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1426 ALTAMONT AVE
SCHENECTADY NY
12303-2979
US

IV. Provider business mailing address

1426 ALTAMONT AVE
SCHENECTADY NY
12303-2979
US

V. Phone/Fax

Practice location:
  • Phone: 518-355-0795
  • Fax: 518-355-1208
Mailing address:
  • Phone: 518-355-0795
  • Fax: 518-355-1208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MS. SARAH R BERETZ
Title or Position: BILLING CLERK
Credential:
Phone: 518-355-0795