Provider Demographics
NPI:1912073693
Name:AMSTERDAM EYE CENTER
Entity Type:Organization
Organization Name:AMSTERDAM EYE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:WIGHT
Authorized Official - Last Name:LOPASIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-690-7020
Mailing Address - Street 1:5010 STATE HIGHWAY 30
Mailing Address - Street 2:SUITE 202
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5010 STATE HIGHWAY 30
Practice Address - Street 2:SUITE 202
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-690-7020
Practice Address - Fax:518-690-7022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01861389Medicaid
2006052510700969OtherMVP
795OtherCDPHP GROUP
10027384OtherCDPHP
NY01861389Medicaid
NYBA0016Medicare ID - Type Unspecified