Individual
DR. GARY J LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
200 MIDWAY PARK DR, MIDDLETOWN, NY 10940-2642
(845) 343-6919
(845) 343-4545
Mailing address
200 MIDWAY PARK DR, MIDDLETOWN, NY 10940-2642
(845) 343-6919
(845) 343-4545
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T5072
NY
Other
Enumeration date
01/04/2006
Last updated
06/25/2010
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