Individual
DIANE BUCOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
321 ALPINE DR, CORTLANDT MANOR, NY 10567-1329
(914) 629-3741
Mailing address
321 ALPINE DR, CORTLANDT MANOR, NY 10567-1329
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
8537-01
NY
Other
Enumeration date
12/08/2020
Last updated
12/08/2020
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