Provider Demographics
NPI:1235343575
Name:TROY OPTOMETRIC
Entity Type:Organization
Organization Name:TROY OPTOMETRIC
Other - Org Name:AMSTERDAM EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:T
Authorized Official - Last Name:BELHUMEUR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:518-274-8181
Mailing Address - Street 1:101 SANFORD FARM ROAD
Mailing Address - Street 2:WALMART VISION CENTER
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010
Mailing Address - Country:US
Mailing Address - Phone:518-843-0189
Mailing Address - Fax:518-843-0460
Practice Address - Street 1:101 SANFORD FARM RD
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-843-0189
Practice Address - Fax:518-843-0460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00544963Medicaid
RA1614Medicare ID - Type Unspecified
U53536Medicare UPIN
NY00544963Medicaid