Provider Demographics
NPI:1326009002
Name:DEERE, HEATHER L (OD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:DEERE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:SINISGALLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 POND VW
Mailing Address - Street 2:SUITE 101
Mailing Address - City:S SCHODACK
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9750
Mailing Address - Country:US
Mailing Address - Phone:518-477-2391
Mailing Address - Fax:518-477-2393
Practice Address - Street 1:3 ATRIUM DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1417
Practice Address - Country:US
Practice Address - Phone:518-438-5273
Practice Address - Fax:518-438-5398
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0067051152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02641803Medicaid
NY02641803Medicaid
NYRB3266Medicare PIN
J400005114Medicare PIN