Individual
MRS. BRIDGET JAYLENE RABIDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 FINNY BLVD, MALONE, NY 12953
(518) 483-0109
(518) 483-0115
Mailing address
155 FINNY BLVD, MALONE, NY 12953
(518) 483-0109
(518) 483-0115
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
009005-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01995615
—
NY
Enumeration date
04/07/2010
Last updated
04/07/2010
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