Provider Demographics
NPI:1952441362
Name:DRS. MADIGAN AND GIBBONS OPTOMETRIST PC
Entity Type:Organization
Organization Name:DRS. MADIGAN AND GIBBONS OPTOMETRIST PC
Other - Org Name:RHINEBECK EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MADIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:845-876-2222
Mailing Address - Street 1:6805 ROUTE 9
Mailing Address - Street 2:SUITE 27
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1148
Mailing Address - Country:US
Mailing Address - Phone:845-876-2222
Mailing Address - Fax:845-876-2045
Practice Address - Street 1:6805 ROUTE 9
Practice Address - Street 2:SUITE 27
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1148
Practice Address - Country:US
Practice Address - Phone:845-876-2222
Practice Address - Fax:845-876-2045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4378650001Medicare NSC