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General NPI Number Information
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NPI Number | 1528770252
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Entity Type | Organization
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Legal Business Name | COLUMBIA GREENE OPTOMETRY PLLC
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 183 HEALY BLVD
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City | HUDSON
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State | NY
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Zip | 12534-1509
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Country | US
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Telephone | 518-828-8733
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Fax | 518-828-4898
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Provider Business Mailing Address
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Address Line | 5315 ROUTE 32
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City | CATSKILL
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State | NY
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Zip | 12414-6527
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Country | US
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Telephone | 845-559-3288
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. VICTORIA MCEWAN
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Credential | OD
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Telephone | 518-828-8733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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