Provider Demographics
NPI:1508632902
Name:ANDRE-JOSEPH, LOUISE MARGARETTE (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:MARGARETTE
Last Name:ANDRE-JOSEPH
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 NORTHWEST RD
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-8310
Mailing Address - Country:US
Mailing Address - Phone:518-588-2292
Mailing Address - Fax:
Practice Address - Street 1:24 QUAKER RDG
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1556
Practice Address - Country:US
Practice Address - Phone:518-746-4159
Practice Address - Fax:518-761-3074
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01053701156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician