Provider Demographics
NPI:1396305934
Name:VANDERHOOF, JOSHUA EVERETT (OD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:EVERETT
Last Name:VANDERHOOF
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 1:4155 WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:13476-4629
Mailing Address - Country:US
Mailing Address - Phone:315-271-7347
Mailing Address - Fax:
Practice Address - Street 1:131 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-1641
Practice Address - Country:US
Practice Address - Phone:315-363-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008954152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist