Provider Demographics
NPI:1992848204
Name:ROJEK, DAVID A (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:ROJEK
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 1:206 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2627
Mailing Address - Country:US
Mailing Address - Phone:518-584-2620
Mailing Address - Fax:518-584-3979
Practice Address - Street 1:11 CHURCH ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-3049
Practice Address - Country:US
Practice Address - Phone:518-725-5416
Practice Address - Fax:518-725-3811
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004180-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00852048Medicaid
NY0470010004OtherDME
NY0470010002OtherDME
NY0470010001OtherDME
NY0470010002OtherDME
NYCC9555Medicare ID - Type Unspecified
NYCC9552Medicare ID - Type Unspecified
NY00852048Medicaid