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Individual

DR. IVANNA STEPANIVNA GRYNYK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
450 MARGARET ST, PLATTSBURGH, NY 12901-1755
(518) 566-2020
Mailing address
8458 PARTRIDGE WAY, CLAY, NY 13041-8723

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
TA2800
MD
152W00000X
Optometrist
Primary
TUV009521
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07104158
NY
Enumeration date
05/31/2021
Last updated
08/10/2022
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