Individual
DR. BRIAN P MAILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1698 STATE ROUTE 7, COBLESKILL, NY 12043-5750
(518) 234-2931
(518) 234-0140
Mailing address
PO BOX 597, COBLESKILL, NY 12043-0597
(518) 234-2931
(518) 234-0140
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV0068031
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02632391
—
NY
Enumeration date
10/04/2005
Last updated
03/07/2017
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