Provider Demographics
NPI:1598278772
Name:TROIDL, ERIC MICHAEL
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:MICHAEL
Last Name:TROIDL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 MILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2843
Mailing Address - Country:US
Mailing Address - Phone:716-289-6919
Mailing Address - Fax:
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
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC6349-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician