Provider Demographics
NPI:1184738270
Name:PARTRIDGE, EUGENE THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:THOMAS
Last Name:PARTRIDGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2793 SOUTH PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:LACKAWANNA
Mailing Address - State:NY
Mailing Address - Zip Code:14218
Mailing Address - Country:US
Mailing Address - Phone:716-826-5555
Mailing Address - Fax:716-826-2922
Practice Address - Street 1:2793 SOUTH PARK AVENUE
Practice Address - Street 2:
Practice Address - City:LACKAWANNA
Practice Address - State:NY
Practice Address - Zip Code:14218
Practice Address - Country:US
Practice Address - Phone:716-826-5555
Practice Address - Fax:716-826-2922
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086159207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0800037OtherJHA
000503416001OtherBC/BS
B35809Medicare UPIN
0800037OtherJHA