Healthcare Provider Details

I. General information

NPI: 1902771892
Provider Name (Legal Business Name): ROY KLINE OPTOMETRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 ULSTER AVE
LAKE KATRINE NY
12449-5420
US

IV. Provider business mailing address

1636 ULSTER AVE
LAKE KATRINE NY
12449-5420
US

V. Phone/Fax

Practice location:
  • Phone: 845-336-6310
  • Fax: 845-336-8573
Mailing address:
  • Phone: 845-336-6310
  • Fax: 845-336-8573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROY ANDREW KLINE
Title or Position: OWNER
Credential: OD
Phone: 518-796-6612