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Organization

OPTICAL DISPENSARY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRUCE C. MINGER (PRESIDENT)
(315) 331-7917
Entity
Organization

Contact information

Practice address
117 E UNION ST, NEWARK, NY 14513-1503
(315) 331-7917
(315) 331-7917
Mailing address
117 E UNION ST, NEWARK, NY 14513-1503
(315) 331-7917
(315) 331-7917

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
004325
NY
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
017510226
BC/BS PROVIDER#
NY
05
01782085
NY
01
103080CT
PREFERRED CARE PROVIDER#
NY
Enumeration date
07/07/2006
Last updated
07/28/2022
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