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Individual

KEITH WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
141 WASHINGTON AVENUE EXT, ALBANY, NY 12205-5609
(518) 217-6008
(518) 217-6004
Mailing address
1475 WESTERN AVE, STE 51 #38008, ALBANY, NY 12203-3520
(518) 217-6008
(182) 176-0045

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV009274
NY
152WC0802X
Corneal and Contact Management Optometrist
TUV009274
NY
152WP0200X
Pediatric Optometrist
TUV009274
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06488393
NY
Enumeration date
01/25/2006
Last updated
05/20/2022
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