Individual
CHARLES SAN GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1754 SHERIDAN DR, BUFFALO, NY 14223-1212
(716) 874-4600
Mailing address
1754 SHERIDAN DR, BUFFALO, NY 14223-1212
(716) 874-4600
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
C00341-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NY3441
EYEMED
NY
Enumeration date
04/27/2018
Last updated
04/27/2018
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