Individual
MR. MARK ANDREW DIVIETRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
97 GENESEE STREET, SILBERT OPTICAL INC, AUBURN, NY 13021-3683
(315) 253-7032
(315) 252-6377
Mailing address
97 GENESEE STREET, SILBERT OPTICAL INC, AUBURN, NY 13021-3683
(315) 253-7032
(315) 252-6377
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C0067671
NY
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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