Individual
MARY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
902 MAIN ST, BUFFALO, NY 14202-1403
(716) 883-9550
Mailing address
366 EVERGREEN DR, TONAWANDA, NY 14150-6406
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
NY5166
NY
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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