Keith Gilbert Mattoon, LICENSEDOPTICIAN
Keith Gilbert Mattoon, LICENSEDOPTICIAN is an Optician in Lakewood, New York. Licensed in New York. Registered with an NPI since 2017.
- Licensed in
- NY
- In the registry since
- 2017
Practice location Address checks out
350 E Fairmount AveLakewood, NY 14750-2134
Phone: (716) 763-0954
Fax: (716) 763-0953
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Optician (primary) | Taxonomy 156FX1800X · Licence 008518 (NY) |
|---|
Record details
| NPI number | 1366958142 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LICENSEDOPTICIAN |
| Sole proprietor | No |
| NPI enumerated | December 16, 2017 |
| Last updated in NPPES | December 16, 2017 |
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