Provider Demographics
NPI:1437108529
Name:FIRSTVIEW EYE CARE ASSOCIATES
Entity Type:Organization
Organization Name:FIRSTVIEW EYE CARE ASSOCIATES
Other - Org Name:CHARLES W PAEPKE
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAEPKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-563-5460
Mailing Address - Street 1:202 W BAY PLZ
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1786
Mailing Address - Country:US
Mailing Address - Phone:518-563-5460
Mailing Address - Fax:518-563-5471
Practice Address - Street 1:202 W BAY PLZ
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1786
Practice Address - Country:US
Practice Address - Phone:518-563-5460
Practice Address - Fax:518-563-5471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2011-05-26
Deactivation Date:2011-05-10
Deactivation Code:
Reactivation Date:2011-05-24
Provider Licenses
StateLicense IDTaxonomies
NYTUV006529-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY415801001OtherBLSHD NE NY
1013966381OtherEXCELLUS
1043268733OtherNPPES
1043268733OtherDME MAC JURISDICTION A
1043268733OtherNPPES
NY0157830001Medicare NSC