Individual
DR. GERALD G MATTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
206 LAKE AVE, SARATOGA SPRINGS, NY 12866-2627
(518) 584-2620
(518) 584-3979
Mailing address
206 LAKE AVE, SARATOGA SPRINGS, NY 12866-2627
(518) 584-2620
(518) 584-3979
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT004160-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00816211
—
NY
Enumeration date
02/15/2007
Last updated
05/04/2020
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