Organization
PARK OPTICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOAN VAN WAGNER (PATIENT SERVICE REPRESENTATIVE)
(845) 338-3302
Entity
Organization
Contact information
Practice address
576-578 BROADWAY, KINGSTON, NY 12401-3902
(845) 338-3302
(845) 338-3483
Mailing address
576-578 BROADWAY, KINGSTON, NY 12401-3902
(845) 338-3302
(845) 338-3483
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
4882
NY
Other
Enumeration date
03/20/2007
Last updated
01/17/2008
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