Individual
LAUREN VAN PAMELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
845 STATE ROUTE 17M, MONROE, NY 10950-1606
(845) 782-0129
Mailing address
19 LAKE STATION RD, WARWICK, NY 10990-3426
(917) 902-9035
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009478
NY
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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