Bryan Prouse, O.D

NPI 1265745004 · on the registry since 2010 · sole proprietor

Practice

Address: 257 Beach 20th St
Far Rockaway, NY 11691
Phone: (718) 327-2020
Fax: (718) 327-6125
Organisation at this address: Barry Scott Raines
Wavecrest Optical Shop
Raines Optical Company, Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy: 152W00000X
152W00000X
Licence states on file: NY
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2020-04-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York