Organization
COSTELLO SR. - ALLEN OPTOMETRISTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW C. ALLEN O.D. (OWNER)
(315) 363-4942
Entity
Organization
Contact information
Practice address
578 SENECA ST, ONEIDA, NY 13421-2600
(315) 363-4942
(315) 363-4441
Mailing address
578 SENECA ST, ONEIDA, NY 13421-2600
(315) 363-4942
(315) 363-4441
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV002717
NY
152W00000X
Optometrist
TUV006131
NY
152W00000X
Optometrist
TUV006206
NY
152W00000X
Optometrist
TUV007184
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02302867
—
NY
05
—
02961255
—
NY
01
—
410039620
RAILROAD MEDICARE
NY
Enumeration date
01/16/2007
Last updated
09/17/2013
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