Individual
MRS. DIANE LYNN FARGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2441 VESTAL PKWY E, VESTAL, NY 13850-2001
(607) 770-6297
(607) 766-9582
Mailing address
2441 VESTAL PKWY E, VESTAL, NY 13850-2001
(607) 770-6297
(607) 766-9582
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009393
NY
Other
Enumeration date
03/18/2019
Last updated
03/18/2019
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