Individual
CAROLYN ANNE LONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
312 ROANOKE AVE, RIVERHEAD, NY 11901-2723
(631) 727-3274
Mailing address
312 ROANOKE AVE, RIVERHEAD, NY 11901-2723
(631) 727-3274
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C003396
NY
Other
Enumeration date
11/20/2007
Last updated
05/20/2008
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