Individual
KEVIN ALAN GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
210 CORNELIA ST, SUITE 302, PLATTSBURGH, NY 12901-2318
(515) 561-8820
Mailing address
PO BOX 176, 56 LAKE ST, PORT KENT, NY 12975-0176
(518) 578-0425
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
7991
NY
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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