Michael D Lack OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV003563-1 Issued in NY

Legal business name

MICHAEL D LACK OD

Practice address

292 Cornelia St BLDG 2
Plattsburgh, NY 12901-2303

Phone

(518) 563-7400

NPI assigned

Jan 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael David Lack, O.D.

Title

Owner

Phone

(518) 563-7400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Country Optical Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George M Mitsoglou, O.D.

  • Optometrist
  • Plattsburgh, NY
  • NPI 1508830191
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1831246958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 CORNELIA ST BLDG 2",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012303",
            "telephone_number": "518-563-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 CORNELIA ST BLDG 2",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012303",
            "telephone_number": "518-563-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D LACK OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "LACK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-563-7400",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003563-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00568070",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Country Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Lee Meyer, PHARMACIST
• Melissa L Meyer, MD
• Robert A Meyer, RPH
• Katharine Meyers, LMHC
• Diana Mhanna, DMD
• Michael T. Davey, DMD, P.C.
• Anna Michalik
• Alan Gregory Michaud, DDS
• Jacob Mihalkovic
• Marilee Ellen Millen, RN

• Optometrist in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.