Provider Demographics
NPI:1871805416
Name:KIRCHHEIMER, DANIEL (OD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:KIRCHHEIMER
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 1:400 PLAZA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3649
Mailing Address - Country:US
Mailing Address - Phone:607-798-1987
Mailing Address - Fax:607-729-8277
Practice Address - Street 1:400 PLAZA DR
Practice Address - Street 2:SUITE B
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3649
Practice Address - Country:US
Practice Address - Phone:607-798-1987
Practice Address - Fax:607-729-8277
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007554152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist