Provider Demographics
NPI:1417082009
Name:BEST, PHILIP CHANDLER (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:CHANDLER
Last Name:BEST
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 BUFFALO ST
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5004
Mailing Address - Country:US
Mailing Address - Phone:716-646-6223
Mailing Address - Fax:
Practice Address - Street 1:183 BUFFALO ST
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-5004
Practice Address - Country:US
Practice Address - Phone:716-646-6223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY3514156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0684708Medicaid
NY0684708Medicaid