Individual
DR. HENRY W MOLE'
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
555 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2750
(716) 664-7601
(716) 664-3353
Mailing address
555 FAIRMOUNT AVE, JAMESTOWN, NY 14701-2750
(716) 664-7601
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005272-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025522301
UNIVERA HEALTHCARE
NY
01
—
003901291
BLUE CROSS OF WNY
NY
01
—
410026682
METRA HEALTH RAILROAD
NY
01
—
5362684
AETNA US HEALTHCARE
NY
Enumeration date
10/18/2005
Last updated
01/04/2013
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