Individual
THOMAS TARASOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1207 TROY SCHENECTADY RD STE 102, LATHAM, NY 12110-1003
(518) 213-4468
(518) 213-4471
Mailing address
1207 TROY SCHENECTADY RD STE 102, LATHAM, NY 12110-1003
(518) 213-4468
(518) 213-4471
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C04068-1
NY
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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