Klark, Raymond A
Klark, Raymond A is an sole proprietor health care provider with primary practice located at 236 Pinewoods Ave , Tonawanda NY 14150-7068. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Klark, Raymond A can be contacted via phone (716) 836-1909.Contact Information
Primary practice address
236 Pinewoods Ave
Tonawanda NY 14150-7068
Phone: (716) 836-1909
Fax: (716) 434-7809
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 4077 | New York |
Profile Details
| NPI number | 1639292535 |
|---|---|
| LBN Legal business name | Klark, Raymond A |
| Credentials | OPTICIAN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 8th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639292535 | NPPES |
| New York | MEDICAID | 00707231 |
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