Individual
DR. GERALD DONALD PRUDHOMME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
601-635 HARRY L DR, SUITE 55, JOHNSON CITY, NY 13790-1246
(607) 797-3519
(607) 798-9009
Mailing address
340 MEEKER RD, VESTAL, NY 13850-3230
(607) 754-8743
(607) 798-9009
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T003782-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01068060
—
NY
Enumeration date
02/15/2007
Last updated
07/09/2007
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