Organization
DR ELISA PERREAULT OPTOMETRIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELISA PERREAULT O.D. (PRESIDENT)
(518) 785-1199
Entity
Organization
Contact information
Practice address
952 TROY SCHENECTADY RD, LATHAM, NY 12110-1608
(518) 785-1199
(518) 785-1199
Mailing address
952 TROY SCHENECTADY RD, LATHAM, NY 12110-1608
(518) 785-1199
(518) 785-1199
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT-005329
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10020324
CDPHP
NY
01
—
4125247
MVP
NY
Enumeration date
04/25/2007
Last updated
10/30/2014
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