Provider Demographics
NPI:1225183023
Name:ARNOLD, BRENT D (OD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:D
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 WESTINGHOUSE ROAD
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-8195
Mailing Address - Country:US
Mailing Address - Phone:607-739-1784
Mailing Address - Fax:607-739-2384
Practice Address - Street 1:2751 WESTINGHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-8195
Practice Address - Country:US
Practice Address - Phone:607-739-1784
Practice Address - Fax:607-739-2384
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0034331152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T26416Medicare UPIN
33170BMedicare ID - Type Unspecified