Provider Demographics
NPI:1770504227
Name:HAMMER, STEVEN CHARLES (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:CHARLES
Last Name:HAMMER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 NORTH COMRIE AVENUE
Mailing Address - Street 2:JOHNSTOWN MALL
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095
Mailing Address - Country:US
Mailing Address - Phone:518-762-9262
Mailing Address - Fax:518-762-4402
Practice Address - Street 1:214 N COMRIE AVE
Practice Address - Street 2:JOHNSTOWN MALL
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-1502
Practice Address - Country:US
Practice Address - Phone:518-762-9262
Practice Address - Fax:518-762-4402
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003455-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU34958Medicare UPIN