Organization
WATERLOO OPHTHALMIC DISPENSING, PC
Active
Organization
WATERLOO OPHTHALMIC DISPENSING, PC
Active
Other names
Waterloo Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL DAVID GOODMAN ABOC (PRESIDENT/OPTICIAN)
(315) 539-1209
Entity
Organization
Contact information
Practice address
204 MAIN STREET SHOP CTR, WATERLOO, NY 13165-1454
(315) 539-1209
(315) 539-1425
Mailing address
204 MAIN STREET SHOP CTR, WATERLOO, NY 13165-1454
(315) 539-1209
(315) 539-1425
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
C004107-1
NY
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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