Provider Demographics
NPI:1093923401
Name:DELLA ROBERTS-MCKAY, OD. PC.
Entity Type:Organization
Organization Name:DELLA ROBERTS-MCKAY, OD. PC.
Other - Org Name:EYEGLASSES FOR LESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DELLA
Authorized Official - Middle Name:SHERYL
Authorized Official - Last Name:ROBERTS-MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:0D
Authorized Official - Phone:845-371-6640
Mailing Address - Street 1:205 ROUTE 59 STE 4
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5236
Mailing Address - Country:US
Mailing Address - Phone:845-371-6640
Mailing Address - Fax:845-371-6659
Practice Address - Street 1:205 ROUTE 59 STE 4
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5236
Practice Address - Country:US
Practice Address - Phone:845-371-6640
Practice Address - Fax:845-371-6659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005533332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01475456Medicaid
NYC06811Medicare UPIN