Provider Demographics
NPI:1861642027
Name:DR. THOMAS M. KAMINKSA, OD
Entity Type:Organization
Organization Name:DR. THOMAS M. KAMINKSA, OD
Other - Org Name:DR. THOMAS M. KAMINKSA, OD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHRADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-631-2020
Mailing Address - Street 1:3356 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-5031
Mailing Address - Country:US
Mailing Address - Phone:716-631-2020
Mailing Address - Fax:716-633-3351
Practice Address - Street 1:3356 GENESEE ST
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-5031
Practice Address - Country:US
Practice Address - Phone:716-631-2020
Practice Address - Fax:716-633-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV3940-1152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0181620001Medicare NSC
NYT88397Medicare UPIN