Organization
ANDREW P SMITH, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW P SMITH O.D. (OPTOMETRIST)
(315) 539-9160
Entity
Organization
Contact information
Practice address
204 MAIN STREET SHOP CTR, WATERLOO, NY 13165-1454
(315) 539-9160
Mailing address
204 MAIN STREET SHOP CTR, WATERLOO, NY 13165-1454
(315) 539-9160
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005146-J
NY
302F00000X
Exclusive Provider Organization
TUV005146-J
NY
332H00000X
Eyewear Supplier
TUV005146-J
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101985CS
PREFERRED CARE
NY
01
—
135462CT
PREFERRED CARE
NY
Enumeration date
02/26/2007
Last updated
04/24/2008
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