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General NPI Number Information
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NPI Number | 1720527369
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Entity Type | Organization
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Legal Business Name | ROBERT K DRUGER DRUGER OPTICAL
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 5633 W GENESEE ST
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City | CAMILLUS
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State | NY
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Zip | 13031-1324
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Country | US
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Telephone | 315-634-1608
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Fax | 315-488-0047
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Provider Business Mailing Address
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Address Line | 5633 W GENESEE ST
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City | CAMILLUS
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State | NY
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Zip | 13031-1324
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Country | US
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Telephone | 315-634-1608
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Fax | 315-488-0047
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT K DRUGER
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Credential | MD
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Telephone | 315-634-1608
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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 | TUV006882
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | C005879-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 006685-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 210355
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License Number State | NY
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