WATERLOO OPHTHALMIC DISPENSING PC NPI 1518199371

NPI Information

  • NPI: 1518199371
  • Provider Name: WATERLOO OPHTHALMIC DISPENSING, PC
  • Classification: Eyewear Supplier - 332H00000X
  • Entity Type: Organization
  • Doing Business As: WATERLOO EYE CARE
  • Address: 204 MAIN STREET SHOP CTR
    WATERLOO, NY
    ZIP 13165
  • Phone: (315) 539-1209

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NPI Details

WATERLOO OPHTHALMIC DISPENSING, PC is an eyewear supplier in Waterloo, NY. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. WATERLOO OPHTHALMIC DISPENSING, PC NPI is 1518199371. The provider is registered as an organization entity type.
The provider Is Doing Business As Waterloo Eye Care.

The provider's business location address is:

204 MAIN STREET SHOP CTR
WATERLOO, NY
ZIP 13165-454
Phone: (315) 539-1209
Fax: (315) 539-1425

The provider's authorized official is Daniel David Goodman .
The authorized official title is President/optician and has the following contact phone number (315) 539-1209.

The enumeration date for this NPI number is 8/12/2009 and was last updated on 8/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierC004107-1NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15944090001MEDICARE UPINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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