Organization
PAK OPTICAL OF WATERTOWN INC
Active
Other names
J Opticians
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ANTHONY KENNEDY JR. OPTICIAN NYS LICENSE (PRESIDENT)
(315) 782-8860
Entity
Organization
Contact information
Practice address
111 MAIN STREET, OGDENSBURG, NY 13669-1116
(315) 393-7754
(315) 782-8863
Mailing address
111 COURT STREET, WATERTOWN, NY 13601-2534
(315) 782-8860
(315) 782-8863
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C4952
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01687530
—
NY
Enumeration date
11/16/2006
Last updated
08/22/2020
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