Provider Demographics
NPI:1669433355
Name:ROHLEDER, DANA C (OD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:C
Last Name:ROHLEDER
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 1:450 MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1755
Mailing Address - Country:US
Mailing Address - Phone:518-566-2020
Mailing Address - Fax:518-566-2020
Practice Address - Street 1:110 CONSUMER SQUARE
Practice Address - Street 2:EMPIRE VISION CENTERS
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-562-0200
Practice Address - Fax:518-562-3647
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0059031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U67068Medicare UPIN
NYCC5408Medicare ID - Type Unspecified