Individual
GALO ANDRADE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
123 STATE ROUTE 94 S STE 2, WARWICK, NY 10990-3664
(347) 581-5135
Mailing address
123 STATE ROUTE 94 S STE 2, WARWICK, NY 10990-3664
(347) 581-5135
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
852714314
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
852714314
LICENSE
NY
Enumeration date
09/12/2020
Last updated
09/12/2020
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