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Individual

STEPHANIE CUSHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LDO

Contact information

Practice address
1210 DRIVING PARK AVE, NEWARK, NY 14513-1057
(315) 331-8921
Mailing address
325 WEST ST, CANANDAIGUA, NY 14424-1787
(585) 394-2020

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C-008116-1
NY

Other

Enumeration date
03/28/2018
Last updated
03/28/2018
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