Individual
BENJAMIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8395 OSWEGO RD, LIVERPOOL, NY 13090
(315) 622-3500
Mailing address
152 MILNOR AVE, LACKAWANNA, NY 14218-3539
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV009150
NY
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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