Provider Demographics
NPI:1497972863
Name:EYECARE FOR THE ADIRONDACKS
Entity Type:Organization
Organization Name:EYECARE FOR THE ADIRONDACKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:GABRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-483-0065
Mailing Address - Street 1:14861 STATE ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-4816
Mailing Address - Country:US
Mailing Address - Phone:518-483-0065
Mailing Address - Fax:
Practice Address - Street 1:14861 STATE ROUTE 30
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-4816
Practice Address - Country:US
Practice Address - Phone:518-483-0065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005844-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty