Organization
OPTICAL SHOP OF CLIFTON PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT E BRASS MD (MEMBER)
(518) 782-7827
Entity
Organization
Contact information
Practice address
1783 ROUTE 9, SUITE 106, CLIFTON PARK, NY 12065-2409
(518) 348-2062
Mailing address
1783 ROUTE 9, SUITE 106, CLIFTON PARK, NY 12065-2409
(518) 348-2062
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
004953-1
NY
156FX1800X
Optician
005490-1
NY
Other
Enumeration date
07/29/2016
Last updated
01/26/2017
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