Individual
AUTUMN HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
139 MERCHANT PL, COBLESKILL, NY 12043-5715
(518) 234-1155
(518) 254-0691
Mailing address
139 MERCHANT PL, COBLESKILL, NY 12043-5715
(518) 234-1155
(518) 254-0691
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
010744
NY
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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