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General NPI Number Information
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NPI Number | 1346418589
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Entity Type | Organization
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Legal Business Name | PERRY OPTICAL
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 1283 ARSENAL ST PRICE CHOPPER PLAZA
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City | WATERTOWN
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State | NY
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Zip | 13601-2252
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Country | US
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Telephone | 315-786-0133
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Fax | 315-786-8516
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Provider Business Mailing Address
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Address Line | 1283 ARSENAL ST PRICE CHOPPER PLAZA
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City | WATERTOWN
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State | NY
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Zip | 13601-2252
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Country | US
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Telephone | 315-786-0133
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Fax | 315-786-8516
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Authorized Official
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Title or Position | OWNER/MANAGER/OPTICIAN
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Name | MICHELE MARY PERRY
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Credential |
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Telephone | 315-786-0133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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