Keith Mattoon, LICENSED OPTICIAN

NPI 1366958142 · on the registry since 2017

Practice

Address: 350 E Fairmount Ave
Lakewood, NY 14750
Phone: (716) 763-0954
Fax: (716) 763-0953
Organisation at this address: Wal-Mart Stores East Lp
Wal-Mart Stores East, Lp
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 156FX1800X
156FX1800X
Licence states on file: NY
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2017-12-16

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