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General NPI Number Information
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NPI Number | 1588188973
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Entity Type | Individual
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Provider Name | ADRIAN MONTES OD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2017
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Last Update Date | 07/28/2017
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Provider Practice Location Address
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Address Line | 6859 E GENESEE ST
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City | FAYETTEVILLE
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State | NY
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Zip | 13066-1086
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Country | US
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Telephone | 315-251-2206
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Fax |
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Provider Business Mailing Address
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Address Line | 225 WILKINSON ST APT 316
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City | SYRACUSE
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State | NY
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Zip | 13204-2450
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Country | US
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Telephone | 651-621-9126
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TUV008641-1
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License Number State | NY
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