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General NPI Number Information
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NPI Number | 1811025281
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Entity Type | Organization
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Legal Business Name | KWIAT OPHTHALMOLOGY PLLC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 234 THORNBERRY LN
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City | RENSSELAER
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State | NY
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Zip | 12144-8452
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Country | US
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Telephone | 315-736-8698
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Fax |
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Provider Business Mailing Address
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Address Line | 11 CALAIS DR
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City | WHITESBORO
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State | NY
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Zip | 13492-2508
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Country | US
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Telephone | 315-736-8698
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID M KWIAT
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Credential | MD
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Telephone | 518-265-1610
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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 | 226627
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License Number State | NY
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