Individual
MARK RAYMOND MAXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
720 UNIVERSITY AVE, STE 110, SYRACUSE, NY 13210-1702
(315) 425-0373
(315) 425-0373
Mailing address
720 UNIVERSITY AVE, STE 110, SYRACUSE, NY 13210-1702
(315) 425-0373
(315) 425-0374
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV0051831
NY
Other
Enumeration date
01/30/2007
Last updated
02/10/2021
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