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Organization

MIDDLETOWN EYE CARE OD PC

Active
Parent organization
MIDDLETOWN EYE CARE OD PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
MIDDLETOWN EYE CARE OD PC
Authorized official
MRS. GRACE MATOS OD (OPTOMETRIST)
(845) 692-0709
Entity
Organization

Contact information

Practice address
1 NORTH GALLERIA DRIVE STE 26, MIDDLETOWN, NY 10941-3018
(845) 692-0709
Mailing address
1 NORTH GALLERIA DRIVE STE 26, MIDDLETOWN, NY 10941-3018
(845) 692-0709

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1700088481
NY
05
1760683437
NY
Enumeration date
02/03/2022
Last updated
02/03/2022
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