Provider Demographics
NPI:1417136292
Name:TWIN TIERS EYE CARE ASSOCIATES, PC
Entity Type:Organization
Organization Name:TWIN TIERS EYE CARE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-734-2984
Mailing Address - Street 1:207 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3204
Mailing Address - Country:US
Mailing Address - Phone:607-734-2984
Mailing Address - Fax:607-398-3411
Practice Address - Street 1:1805 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ENDICOTT
Practice Address - State:NY
Practice Address - Zip Code:13760-5531
Practice Address - Country:US
Practice Address - Phone:607-748-3434
Practice Address - Fax:607-398-3408
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TWIN TIERS EYE CARE ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-30
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
52490AMedicare PIN
0872680001Medicare NSC