Individual
CARMEN BURLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
48 MAIN ST, MASSENA, NY 13662-1984
(315) 764-7001
Mailing address
48 MAIN ST, MASSENA, NY 13662-1984
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
004732
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00673327
—
NY
Enumeration date
01/29/2007
Last updated
12/22/2008
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