National Provider Identifier
Raymond A Klark Jr., OPTICIAN
Raymond A Klark Jr., OPTICIAN is listed in the NPPES registry with a primary specialty of Optician in Tonawanda, NY and a listed phone number of (716) 836-1909.
Profile Overview
- NPI
- 1639292535
- Provider Type
- Individual
- Primary Specialty
- Optician
- Enumeration Date
- April 08, 2007
- Last Updated
- July 09, 2007
Practice Location
- 236 Pinewoods Ave
- Tonawanda, NY 14150-7068
Phone: (716) 836-1909
Specialties
- Optician (156FX1800X)
Full Record
- NPI
- 1639292535
- Entity Type
- Individual
- Last Name
- Klark
- First Name
- Raymond
- Middle Name
- A
- Name Prefix
- Mr.
- Name Suffix
- Jr.
- Credential
- OPTICIAN
- Mailing Street Address
- 236 Pinewoods Ave
- Mailing City
- Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14150-7068
- Mailing Country
- US
- Mailing Phone
- (716) 836-1909
- Mailing Fax
- (716) 434-7809
- Practice Street Address
- 236 Pinewoods Ave
- Practice City
- Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14150-7068
- Practice Country
- US
- Practice Phone
- (716) 836-1909
- Practice Fax
- (716) 434-7809
- Enumeration Date
- April 08, 2007
- Last Updated
- July 09, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optician (156FX1800X)
- Other Identifiers
- 00707231 (NY)