Individual
BRIAN EUGENE BLEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
406 E 4TH ST, WATKINS GLEN, NY 14891-1217
(607) 535-4842
(607) 398-3413
Mailing address
207 MADISON AVE, ELMIRA, NY 14901-3204
(607) 734-2984
(607) 398-3411
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT005098
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410020897
RR MEDICARE
—
Enumeration date
09/20/2005
Last updated
01/25/2012
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