Individual
MICHAEL THOMAS DULAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
3876 SOUTH PARK AVE, BLASDELL, NY 14219
(716) 822-2264
(716) 826-3068
Mailing address
57 SAWGRASS CT, HAMBURG, NY 14075
(716) 649-0436
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
3845
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00917226
—
NY
Enumeration date
02/27/2007
Last updated
07/08/2007
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