Provider Demographics
NPI:1215901947
Name:CHENARIDES, VICKI L (OD)
Entity type:Individual
Prefix:DR
First Name:VICKI
Middle Name:L
Last Name:CHENARIDES
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:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-0459
Mailing Address - Country:US
Mailing Address - Phone:845-227-2233
Mailing Address - Fax:
Practice Address - Street 1:857 ROUTE 82
Practice Address - Street 2:
Practice Address - City:HOPEWELL JCT
Practice Address - State:NY
Practice Address - Zip Code:12533-0209
Practice Address - Country:US
Practice Address - Phone:845-227-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004725152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist