Healthcare Provider Details

I. General information

NPI: 1194952044
Provider Name (Legal Business Name): TOCHUKU C NKADI O.D, M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3039 ROUTE # 50 EMPIRE VISION CENTERS
SARATOGA SPRINGS NY
12866-2937
US

IV. Provider business mailing address

3039 ROUTE # 50 EMPIRE VISION CENTERS
SARATOGA SPRINGS NY
12866-2937
US

V. Phone/Fax

Practice location:
  • Phone: 518-580-1117
  • Fax: 518-580-1311
Mailing address:
  • Phone: 518-580-1117
  • Fax: 518-580-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV 007395-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: