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Individual

LORI A YOUNGMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
147 W 1ST ST, OSWEGO, NY 13126-2045
(315) 343-2020
(315) 207-2001
Mailing address
147 W 1ST ST, OSWEGO, NY 13126-2045
(315) 343-2020
(315) 207-2001

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007521-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410028898
RAILROAD MEDICARE
WA
01
410032420
RAILROAD MEDICARE
WA
01
410045035
RAILROAD MEDICARE
WA
01
410045497
RAILROAD MEDICARE
ID
Enumeration date
08/24/2006
Last updated
04/09/2013
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