Provider Demographics
NPI:1225340342
Name:FURTADO, NADINE MARIA (OD)
Entity Type:Individual
Prefix:DR
First Name:NADINE
Middle Name:MARIA
Last Name:FURTADO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CALAIS
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H9H 3V3
Mailing Address - Country:CA
Mailing Address - Phone:646-322-3443
Mailing Address - Fax:
Practice Address - Street 1:2094 ALBANY POST RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-1454
Practice Address - Country:US
Practice Address - Phone:914-737-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2010-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007559-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist