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General NPI Number Information
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NPI Number | 1871759290
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Entity Type | Organization
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Legal Business Name | SILHOUETTE EYE STUDIO LLC
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 5 ULENSKI DRIVE
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City | ALBANY
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State | NY
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Zip | 12205
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Country | US
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Telephone | 518-944-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 5 ULENSKI DR
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City | ALBANY
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State | NY
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Zip | 12205-1103
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Country | US
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Telephone | 518-944-2300
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Fax | 518-944-2399
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Authorized Official
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Title or Position | INSURANCE BILLING/TECHNICIAN
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Name | MS. KRISTY MINER
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Credential |
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Telephone | 518-944-2300
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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 | TUV006630
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License Number State | NY
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