Provider Demographics
NPI:1841295292
Name:SARIKEY, PHILIP A (OD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:A
Last Name:SARIKEY
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:PO BOX 1340
Mailing Address - Street 2:2 HUGHEY ALY
Mailing Address - City:ELLICOTTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14731-1340
Mailing Address - Country:US
Mailing Address - Phone:716-699-5293
Mailing Address - Fax:
Practice Address - Street 1:2 HUGHEY ALLEY
Practice Address - Street 2:
Practice Address - City:ELLICOTTVILLE
Practice Address - State:NY
Practice Address - Zip Code:14731
Practice Address - Country:US
Practice Address - Phone:716-699-5293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-14
Last Update Date:2017-01-30
Deactivation Date:2005-07-19
Deactivation Code:
Reactivation Date:2005-08-02
Provider Licenses
StateLicense IDTaxonomies
NYTUV005139152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
285183Medicare ID - Type Unspecified
NYU20783Medicare UPIN