Provider Demographics
NPI:1477991214
Name:ALLFREY, KEVIN M (OD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:ALLFREY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 ULSTER AVE
Mailing Address - Street 2:STE.259
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-1501
Mailing Address - Country:US
Mailing Address - Phone:845-336-4141
Mailing Address - Fax:866-447-1426
Practice Address - Street 1:1300 ULSTER AVE STE 259
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-8103
Practice Address - Country:US
Practice Address - Phone:845-336-4141
Practice Address - Fax:866-447-1426
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003618-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist