Individual
DALE S CLEMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
156FC0801X
Contact Lens Fitter
C006828
NY
156FX1800X
Optician
Primary
C006828
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C006828
OPHTHALMIC DISPENSING LIC
NY
01
—
NY6828
EYEMED PROVIDER NUMBER
NY
Enumeration date
01/02/2007
Last updated
06/27/2011
Update your record
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