Organization
OPTICS OF TICONDEROGA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN ELLEN TITUS LPO (PRESIDENT)
(518) 585-4000
Entity
Organization
Contact information
Practice address
89 MONTCALM ST, TICONDEROGA, NY 12883-1385
(518) 585-4000
(518) 585-5286
Mailing address
89 MONTCALM ST, TICONDEROGA, NY 12883-1385
(518) 585-4000
(518) 585-5286
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
008987
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03126203
—
NY
Enumeration date
09/16/2010
Last updated
12/26/2014
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