Individual
JESSICA R DUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ABOC
Contact information
Practice address
135 COUNTY HIGHWAY 128, JOHNSTOWN, NY 12095-3823
(518) 762-2020
Mailing address
135 COUNTY HIGHWAY 128, JOHNSTOWN, NY 12095-3823
(518) 762-2020
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
5539351
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02772498
—
NY
Enumeration date
02/02/2007
Last updated
07/08/2007
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