Provider Demographics
NPI:1396878765
Name:THOMAS TURTLE OPTICIANS INC.
Entity type:Organization
Organization Name:THOMAS TURTLE OPTICIANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:T
Authorized Official - Last Name:TURTLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-693-1280
Mailing Address - Street 1:444 PAYNE AVE
Mailing Address - Street 2:P.O. BOX 830
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-6902
Mailing Address - Country:US
Mailing Address - Phone:716-693-1280
Mailing Address - Fax:716-693-1383
Practice Address - Street 1:444 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6902
Practice Address - Country:US
Practice Address - Phone:716-693-1280
Practice Address - Fax:716-693-1383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY5265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0597890001OtherMEDICARE DME
0597890003OtherMEDICARE DME
00025972201OtherUNIVERA
000300010003OtherBCBS
000300010001OtherBCBS
NY5265OtherEYEMED
000300010007OtherBCBS
000300010005OtherBCBS
7309539OtherINDEPENDENT HEALTH
0597890002OtherMEDICARE DME
NY0597890004OtherMEDICARE DME
NYT52533Medicare PIN
000300010003OtherBCBS
NY0597890001Medicare NSC
0597890002OtherMEDICARE DME
U21406Medicare UPIN
NY0597890003Medicare NSC
000300010007OtherBCBS