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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