Provider Demographics
NPI:1366438350
Name:ROODNER, DEBORAH CHAVA (OD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:CHAVA
Last Name:ROODNER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-0459
Mailing Address - Country:US
Mailing Address - Phone:845-227-2233
Mailing Address - Fax:845-227-4186
Practice Address - Street 1:857 ROUTE 82
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-7347
Practice Address - Country:US
Practice Address - Phone:845-227-2233
Practice Address - Fax:845-227-4186
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 004051152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist