Healthcare Provider Details

I. General information

NPI: 1942344148
Provider Name (Legal Business Name): SARATOGA OPTOMETRIC ASSOC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 WASHINGTON ST STE 1
SARATOGA SPRINGS NY
12866-5962
US

IV. Provider business mailing address

235 WASHINGTON ST STE 1
SARATOGA SPRINGS NY
12866-5962
US

V. Phone/Fax

Practice location:
  • Phone: 518-587-5900
  • Fax: 518-587-5938
Mailing address:
  • Phone: 518-587-5900
  • Fax: 518-587-5938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV003537
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberTUV003537
License Number StateNY

VIII. Authorized Official

Name: DR. DALE CHING
Title or Position: PRESIDENT
Credential: OD
Phone: 518-587-5900