WENDY ODDO OPTICIAN, NPI 1184127896 — AMHERST (NY)

NPI 1184127896

1+ Years Experience Individual

WENDY ODDO OPTICIAN

03.09.2018
PROVIDER ENUMERATION DATE
03.09.2018
LAST UPDATE DATE
1184127896
NPI NUMBER

About WENDY ODDO

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

WENDY ODDO is a provider established in AMHERST, NY. The NPI number of WENDY ODDO is 1184127896 and was assigned on 03.09.2018. The practitioners primary taxonomy code is: 156FX1800X with license number: 005182-1 NY .

Mailing address

  • City: AMHERST
  • State: NY
  • Postal code: 142261727
  • Phone: 7163620651
  • Address: 3980 SHERIDAN DR STE 402

Primary Practice Address

  • Region : AMHERST, NY
  • NPI : 1184127896
  • Phone : 7163620651
  • Postalcode : 142261727
  • Address : 3980 SHERIDAN DR STE 402

Additional identifiers

  • Identifier: 1376924944
  • Code / Type : 5 - MEDICAID
  • Identifier state : NY

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Technician/Technologist

  • Taxonomy code: 156FX1800X
  • License number: 005182-1
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • WENDY ODDO OPTICIAN
  • Address : 3980 SHERIDAN DR STE 402
  • Region : AMHERST, NY
  • NPI : 1184127896
  • Phone : 7163620651
  • Postalcode : 142261727

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3980 SHERIDAN DR STE 402
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameAMHERST
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code142261727
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number7163620651
The telephone number associated with the location address of the provider being identified.
NPI1184127896
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1156FX1800X
Provider Enumeration Date03.09.2018
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated03.09.2018
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)WENDY ODDO
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address3980 SHERIDAN DR STE 402
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameAMHERST
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code142261727
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7163620651
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1156FX1800X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Technician/Technologist
Provider License Number 1005182-1
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 11376924944
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1NY
Other Provider Identifier State #1
Provider Gender CodeF
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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