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NPI Code Detail

MEDICARE: DR. RICHARD CHRISTIAN MALARA O.D.

MEDICARE:  DR. RICHARD CHRISTIAN MALARA  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristTU005325-1NY
2152WC0802XCorneal and Contact Management OptometristTU005325-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11336346550OTHERNYCORPORATE NPI
21386634210OTHERNYINDIVIDUAL NPI

General Provider Information

NPI Number : 1386634210
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD CHRISTIAN MALARA O.D.
Provider Business Mailing Address
First Line : 8395 OSWEGO RD
Second Line :
City : BALDWINSVILLE
State : NY
Zip : 13027-6801
Country : US
Telephone Number : 315-622-3500
Fax Number : 315-622-3522
Provider Business Practice Location Address
First Line : 8395 OSWEGO RD
Second Line : KIMBROOK VILLAGE SQUARE
City : BALDWINSVILLE
State : NY
Zip : 13027-6801
Country : US
Telephone Number : 315-622-3500
Fax Number : 315-622-3522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2005
Last Update Date : 06/10/2011

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Directions to “ DR. RICHARD CHRISTIAN MALARA O.D.” Practice Location

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