Cohoes Eye Associates, LLC
Organization Active NPI Optometrist · Cohoes, NY
NPI 1780194407 · NPPES record last updated Sep 24, 2018
Key facts
- NPI
- 1780194407
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- TUV005872 (NY)
- Legal business name
- COHOES EYE ASSOCIATES, LLC
- Practice address
- 91 Mohawk St
Cohoes, NY 12047-2809 - Phone
- (518) 237-0342
- Fax
- (518) 235-9266
- NPI assigned
- Oct 8, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Kelly Primeau, OD
- Title
- Optometrist
- Phone
- (518) 233-0463
Practitioners 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180209000776 | NY | Part B Supplier - Clinic/Group Practice | 0749540805 |
Receives reassigned benefits from 1 practitioner Practice locations: Cohoes, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | TUV005872 | NY | Yes |
Addresses
Primary practice location
91 Mohawk St
Cohoes, NY 12047-2809
Mailing address
91 Mohawk St
Cohoes, NY 12047
Phone (518) 237-0342
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U70980 | Other | NY | UPIN |
| 02133640 | Medicaid | NY |
Other providers in Cohoes, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.