Provider Demographics
NPI:1184614109
Name:KNAPP, DONALD BRUCE (OD)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:BRUCE
Last Name:KNAPP
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 1:2549 SULPHUR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SAUQUOIT
Mailing Address - State:NY
Mailing Address - Zip Code:13456-3217
Mailing Address - Country:US
Mailing Address - Phone:315-794-8657
Mailing Address - Fax:
Practice Address - Street 1:392 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST WINFIELD
Practice Address - State:NY
Practice Address - Zip Code:13491-2903
Practice Address - Country:US
Practice Address - Phone:315-822-5678
Practice Address - Fax:315-822-5973
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT003992-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0005109317OtherAETNA
NYP010003992OtherBLUEPOINT 2
NYP017002202OtherHMO BLUE OPTION
NY16-1182665OtherTRICARE
NYP010003992OtherEXCELLUS HEALTH PLAN
NY00667230Medicaid
NY16-1182665OtherUNITED HEALTHCARE INSURAN
TX161182665001OtherTODAY'S OPTIONS
TX161182665001OtherAMERICAN PROGRESSIVE
NY595113OtherMVP HEALTH PLAN, INC
NY16-1182665-002OtherRMSCO, INC
NYP017002202OtherMEDICARE BLUE PPO
NY16-1182665OtherEMPIRE PLAN
NY200055337OtherMVP HEALTH PLAN, INC
NYN 1790859965OtherFIRST AMERICAN LIFE INSUR