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General NPI Number Information
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NPI Number | 1366455701
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Entity Type | Organization
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Legal Business Name | OHLBAUM & WATERMAN EYE ASSOCIATES
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 1 PARIS RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-2350
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Country | US
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Telephone | 315-797-9091
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Fax | 315-797-9124
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Provider Business Mailing Address
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Address Line | 1 PARIS ROAD
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City | NEW HARTFORD
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State | NY
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Zip | 13413
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Country | US
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Telephone | 315-797-9091
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Fax | 315-797-9124
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MICHAEL WATERMAN
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Credential | OD
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Telephone | 315-797-9091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT005259
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License Number State | NY
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