Provider Demographics
NPI:1922057975
Name:BARTOLONE, AMELIA G (OD)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:G
Last Name:BARTOLONE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:M
Other - Last Name:GOLEBIEWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:36 SUN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:STONE RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12484-5630
Mailing Address - Country:US
Mailing Address - Phone:848-797-7161
Mailing Address - Fax:
Practice Address - Street 1:80 WASHINGTON ST STE L03
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-2304
Practice Address - Country:US
Practice Address - Phone:845-443-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT005732152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244528Medicaid
NYU67545Medicare UPIN
NYC14251Medicare ID - Type Unspecified