Zachary Kyle Bird, OD
Individual provider Active NPI Optometrist · Vestal, NY
NPI 1104349935 · NPPES record last updated Jul 24, 2017
Key facts
- NPI
- 1104349935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 008670 (NY)
- Practice address
- 2421 Vestal Pkwy E # 5
Vestal, NY 13850-2066 - Phone
- (607) 217-5169
- NPI assigned
- Jul 24, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 008670 | NY | Yes |
Addresses
Primary practice location
2421 Vestal Pkwy E # 5
Vestal, NY 13850-2066
Mailing address
7400 W Arrowhead Clubhouse Dr Apt 2006
Glendale, AZ 85308-8823
Phone (480) 543-9647
Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.