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General NPI Number Information
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NPI Number | 1730207945
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Entity Type | Individual
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Provider Name | MELVILLE LEON MCLEAR DISPENSER
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3 LYON PL SUITE 304
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City | OGDENSBURG
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State | NY
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Zip | 13669-2590
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Country | US
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Telephone | 315-528-5474
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Fax | 315-375-4113
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Provider Business Mailing Address
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Address Line | 2477 COUNTY ROUTE 6
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City | HAMMOND
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State | NY
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Zip | 13646-4118
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Country | US
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Telephone | 315-375-6508
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Fax | 315-375-4113
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 14000003334
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License Number State | NY
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