Provider Demographics
NPI:1598294399
Name:CNY MEDICAL AND SURGICAL EYE CARE PC
Entity Type:Organization
Organization Name:CNY MEDICAL AND SURGICAL EYE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:WEISENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-445-1577
Mailing Address - Street 1:PO BOX 48
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:NY
Mailing Address - Zip Code:13214-0048
Mailing Address - Country:US
Mailing Address - Phone:315-510-3510
Mailing Address - Fax:315-510-3469
Practice Address - Street 1:5109 W GENESEE ST STE 102
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2372
Practice Address - Country:US
Practice Address - Phone:315-487-3937
Practice Address - Fax:315-488-3563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008389-1332B00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies