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General NPI Number Information
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NPI Number | 1053673178
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Entity Type | Organization
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Legal Business Name | AMBIENT
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 1329 SAWKILL RD
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City | KINGSTON
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State | NY
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Zip | 12401
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Country | US
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Telephone | 917-292-1271
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Fax |
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Provider Business Mailing Address
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Address Line | 1329 SAWKILL RD
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City | KINGSTON
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State | NY
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Zip | 12401-7901
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Country | US
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Telephone | 917-292-1271
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Fax |
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Authorized Official
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Title or Position | CHIEF
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Name | TOMAS A TOBLER
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Credential | TVI
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Telephone | 917-292-1271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State | NY
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