Individual
KELLY DIANE FARRAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1105 DRIVING PARK AVE, NEWARK, NY 14513-1069
(315) 331-5721
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
(315) 331-5721
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
005792
NY
Other
Enumeration date
09/26/2006
Last updated
07/23/2019
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