Provider Demographics
NPI:1154404937
Name:KAHLE, ANNETTE (OD)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:
Last Name:KAHLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SOUTH ROAD
Mailing Address - Street 2:SEARS OPTICAL
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-298-3791
Mailing Address - Fax:845-297-7078
Practice Address - Street 1:2001 SOUTH ROAD
Practice Address - Street 2:SEARS OPTICAL
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-298-3791
Practice Address - Fax:845-297-7078
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004750152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist