Organization
TERESA BLACKSTONE OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESA L BLACKSTONE O.D. (PRESIDENT)
(518) 580-9893
Entity
Organization
Contact information
Practice address
414 MAPLE AVE STE 200, SARATOGA SPRINGS, NY 12866-5533
(518) 597-0772
(518) 587-8749
Mailing address
414 MAPLE AVE STE 200, SARATOGA SPRINGS, NY 12866-5533
(518) 597-0772
(518) 587-8749
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT004647
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01419649
—
NY
Enumeration date
12/29/2009
Last updated
12/29/2009
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