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Organization

UPSTATE VISION CARE, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMY L ST.JOHN OPTHALMIC DISPENSER (OWNER/NYS LICENSED OPTICIAN)
(518) 744-7136
Entity
Organization

Contact information

Practice address
206 GLEN ST. SUITE 31B, COLVIN BUILDING, GLENS FALLS, NY 12801
(518) 744-7136
Mailing address
206 GLEN ST. SUITE 31B, COLVIN BUILDING, GLENS FALLS, NY 12801
(518) 744-7136

Taxonomy

Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1275000853
INDIVIDUAL
NY
Enumeration date
12/06/2018
Last updated
12/06/2018
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