Individual
MRS. AMY B INTERNICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED OPTICIAN
Contact information
Practice address
2441 SHERIDAN DR, TONAWANDA, NY 14150-9405
(716) 836-8700
(716) 836-3549
Mailing address
2441 SHERIDAN DR, TONAWANDA, NY 14150-9405
(716) 836-8700
(716) 836-3549
Taxonomy
Speciality
Code
Description
License number
State
156FC0801X
Contact Lens Fitter
Primary
C005694-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C005694-1
LICENSED OPTICIAN
NY
Enumeration date
05/07/2007
Last updated
07/08/2007
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