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General NPI Number Information
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NPI Number | 1164617254
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Entity Type | Organization
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Legal Business Name | EYE CARE MEDICINE SURGERY PC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 357 BAY RD STE 7
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City | QUEENSBURY
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State | NY
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Zip | 12804-3051
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Country | US
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Telephone | 518-798-7449
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Fax |
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Provider Business Mailing Address
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Address Line | 46 ELM ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-3524
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Country | US
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Telephone | 518-793-9820
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Fax | 518-793-7517
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JEANNE PICANO
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Credential |
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Telephone | 518-798-7449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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