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General NPI Number Information
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NPI Number | 1639228729
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Entity Type | Organization
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Legal Business Name | TOWN & COUNTRY OPTICAL,INC.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 535 BAY RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-3018
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Country | US
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Telephone | 518-793-5395
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Fax | 518-793-5543
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Provider Business Mailing Address
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Address Line | 535 BAY RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-3018
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Country | US
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Telephone | 518-793-5395
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Fax | 518-793-5543
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Authorized Official
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Title or Position | OPTICIAN-MANAGER
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Name | MS. KATHLEEN A LARROW
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Credential |
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Telephone | 518-793-5395
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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 | 005800
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License Number State | NY
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