Healthcare Provider Details

I. General information

NPI: 1578600938
Provider Name (Legal Business Name): ANDREA KAISER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 06/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 COLUMBUS AVE
THORNWOOD NY
10594-1909
US

IV. Provider business mailing address

660 COLUMBUS AVE 3-3
THORNWOOD NY
10594-1909
US

V. Phone/Fax

Practice location:
  • Phone: 914-747-2000
  • Fax: 914-747-4032
Mailing address:
  • Phone: 914-747-2000
  • Fax: 914-747-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberNY5840
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: