Individual
DR. JAMES GORDON BEITER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3861 S PARK AVE, BLASDELL, NY 14219-1813
(716) 823-6093
Mailing address
3861 S PARK AVE, BLASDELL, NY 14219-1813
(716) 823-6093
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
56 008059
NY
152W00000X
Optometrist
CODTG00592
RI
Other
Enumeration date
07/08/2013
Last updated
12/05/2014
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