Provider Demographics
NPI:1982639282
Name:PEREIRA, TODD (OD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:TODD
Other - Middle Name:
Other - Last Name:PEREIRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1417 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3009
Mailing Address - Country:US
Mailing Address - Phone:518-374-1882
Mailing Address - Fax:518-374-1777
Practice Address - Street 1:1417 UNION ST
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-3009
Practice Address - Country:US
Practice Address - Phone:518-374-1882
Practice Address - Fax:518-374-1777
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006326152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U98270Medicare UPIN
NYRA8195Medicare PIN
NYRA8198Medicare PIN
NYRA8197Medicare PIN
NYRA8197Medicare PIN