Provider Demographics
NPI:1073823597
Name:WASHTON, DREW ALAN (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:DREW
Middle Name:ALAN
Last Name:WASHTON
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27110 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1532
Mailing Address - Country:US
Mailing Address - Phone:718-962-3040
Mailing Address - Fax:718-962-1253
Practice Address - Street 1:27110 UNION TPKE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1532
Practice Address - Country:US
Practice Address - Phone:718-962-3040
Practice Address - Fax:718-962-1253
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008340156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician