Healthcare Provider Details

I. General information

NPI: 1093711558
Provider Name (Legal Business Name): JEFFREY DAVID VARNEY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1692 CENTRAL AVE
ALBANY NY
12205-4045
US

IV. Provider business mailing address

1692 CENTRAL AVE
ALBANY NY
12205-4045
US

V. Phone/Fax

Practice location:
  • Phone: 518-869-2560
  • Fax: 518-869-2580
Mailing address:
  • Phone: 518-869-2560
  • Fax: 518-869-2580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberV002857
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: