Kenneth L. Stack O.D.

NPI 1093756371 - Optometrist - 152W00000X

NPI Details
NPI 1093756371
Gender Male
Enumeration Date 06/09/2006
Last Updated 10/24/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
24 ROSEMONT ST
ALBANY NY, 12203-2405, US
Phone (518) 438-6669
Fax (518) 489-4372
Business Location
24 ROSEMONT ST
ALBANY NY, 12203-2405, US
Phone (518) 438-6669
Fax (518) 489-4372
Toxanomy
Taxonomy Code 152W00000X
License State New York
License Number TUV004607-1
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According to our database, Dr. Kenneth L. Stack O.D. NPI is 1093756371, taxonomy code is 152W00000X and license number is TUV004607-1, license state is located at New York. Kenneth L. Stack O.D. physically located at 24 Rosemont St, Albany NY, 12203-2405. NPI Number Kenneth L. Stack O.D. has the Individual type.

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1093756371 NPI number is provided on an as is basis without warranty of any kind. 1093756371 is maintained by the National Plan & Provider Enumeration System. The contents of Kenneth L. Stack O.D. are for informational purposes only.