Provider Demographics
NPI:1831947803
Name:WINDOFT, CARTER JOHN (OD)
Entity type:Individual
Prefix:DR
First Name:CARTER
Middle Name:JOHN
Last Name:WINDOFT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:835 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14750-9643
Mailing Address - Country:US
Mailing Address - Phone:716-397-8026
Mailing Address - Fax:
Practice Address - Street 1:462 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-2721
Practice Address - Country:US
Practice Address - Phone:716-484-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG004139152W00000X
NYXX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist