Provider Demographics
NPI:1548265226
Name:GERMAINE, VERONIQUE BAPTISTE (OD, FAAO)
Entity type:Individual
Prefix:DR
First Name:VERONIQUE
Middle Name:BAPTISTE
Last Name:GERMAINE
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LOCKWOOD AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5028
Mailing Address - Country:US
Mailing Address - Phone:914-636-5506
Mailing Address - Fax:914-636-6644
Practice Address - Street 1:110 LOCKWOOD AVE
Practice Address - Street 2:STE 104
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5028
Practice Address - Country:US
Practice Address - Phone:914-636-5506
Practice Address - Fax:914-636-6644
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005465-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01712096Medicaid
NYCEWGD1Medicare PIN