Ludlow, Jonathan P

Ludlow, Jonathan P is an sole proprietor health care provider with primary practice located at 10730A Enduring Freedom Dr Ste A , Fort Drum NY 13602-5405. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ludlow, Jonathan P can be contacted via phone (315) 405-8671.

Contact Information

Primary practice address
10730A Enduring Freedom Dr Ste A Fort Drum NY 13602-5405
Fax: (315) 773-1820
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X TUV0061121 New York

Profile Details

NPI number 1417939604
LBN Legal business name Ludlow, Jonathan P
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2005
Last updated Nov 29th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417939604 NPPES
New York MEDICAID 02008780
New York Other G0185822450
New York Other TUV006112
New York Other 410043899
New York Other 52833A

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