Individual
DR. GARY ALBERT MINECONZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
619 AVIATION RD, QUEENSBURY, NY 12804-1842
(518) 798-6923
Mailing address
98 ROCKWELL RD, QUEENSBURY, NY 12804-7739
(518) 793-2857
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T003570-1
NY
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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