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General NPI Number Information
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NPI Number | 1467894238
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Entity Type | Individual
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Provider Name | CAITRIN E HERDIC OD
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Gender | Female
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 485 WILLARD AVE TOTALVISION EYE HEALTH CENTER
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City | NEWINGTON
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State | CT
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Zip | 06111-2318
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Country | US
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Telephone | 860-666-7053
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Fax |
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Provider Business Mailing Address
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Address Line | 71 SMITHFIELD BLVD
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City | PLATTSBURGH
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State | NY
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Zip | 12901-2136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | TUV008552-1
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License Number State | NY
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