Provider Demographics
NPI:1245580711
Name:AMSTERDAM REC LLC
Entity Type:Organization
Organization Name:AMSTERDAM REC LLC
Other - Org Name:MOHAWK VALLEY EYE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:KWIAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-339-1638
Mailing Address - Street 1:100 HOLLAND CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7551
Mailing Address - Country:US
Mailing Address - Phone:518-842-3800
Mailing Address - Fax:518-842-3900
Practice Address - Street 1:100 HOLLAND CIRCLE DR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7551
Practice Address - Country:US
Practice Address - Phone:518-842-3800
Practice Address - Fax:518-842-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical