Individual
DR. ANGELINA MARIE MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
720 UNIVERSITY AVE, SYRACUSE, NY 13210-1702
(315) 425-0373
Mailing address
6811 WOODCHUCK HILL RD, FAYETTEVILLE, NY 13066-9746
(908) 812-6465
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0003751
CO
152W00000X
Optometrist
2498
NC
152W00000X
Optometrist
5434
FL
152W00000X
Optometrist
Primary
TUV008341
NY
Other
Enumeration date
12/08/2015
Last updated
09/26/2022
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