Provider Demographics
NPI:1194880989
Name:TROIDL OPTICAL
Entity type:Organization
Organization Name:TROIDL OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:TROIDL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-836-4949
Mailing Address - Street 1:665 CLEVELAND DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1042
Mailing Address - Country:US
Mailing Address - Phone:716-836-4949
Mailing Address - Fax:716-836-1517
Practice Address - Street 1:665 CLEVELAND DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-1042
Practice Address - Country:US
Practice Address - Phone:716-836-4949
Practice Address - Fax:716-836-1517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3462152W00000X
NYC6329-1156FC0801X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens FitterGroup - Multi-Specialty
Not Answered156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00300000001OtherBLUE CROSS BLUE SHIELD
NYOP0578OtherEYEMED VISION CARE
NY00300000001OtherBLUE CROSS BLUE SHIELD