Podberesky, Lee
Podberesky, Lee is an sole proprietor health care provider with primary practice located at 358 Mountain Ave , Monroe NY 10950-1114. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Podberesky, Lee can be contacted via phone (845) 782-1837.Contact Information
Primary practice address
358 Mountain Ave
Monroe NY 10950-1114
Phone: (845) 782-1837
Fax: (845) 774-8849
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | T004929-1 | New York |
Profile Details
| NPI number | 1093884496 |
|---|---|
| LBN Legal business name | Podberesky, Lee |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 7th, 2006 |
| 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 | 1093884496 | NPPES |
| New York | MEDICAID | 01691625 |
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