MEDICARE: OLESSIA XENIA BUTENKO OD

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
1	152W00000X	Optometrist	TUV006228	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000125424	OTHER	NY	BCBS
2	366116	OTHER	NY	MVP
3	27761	OTHER	NY	SUPERIOR

General Provider Information

NPI Number	:	1619190493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLESSIA XENIA BUTENKO OD

Provider Business Mailing Address
First Line	:	131 TEMPLE ST
Second Line	:
City	:	OWEGO
State	:	NY
Zip	:	13827-1420
Country	:	US
Telephone Number	:	607-760-9275
Fax Number	:

Provider Business Practice Location Address
First Line	:	3018 EAST AVE
Second Line	:	INSIDE WALMART VISION CENTER
City	:	CENTRAL SQUARE
State	:	NY
Zip	:	13036-2713
Country	:	US
Telephone Number	:	315-668-0422
Fax Number	:	315-668-0424

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	02/15/2012

Similar Medicare Providers

1316964489 — WAL-MART STORES EAST LP
Practice Location Address:

3018 EAST AVE
CENTRAL SQUARE, NY
13036-2713

Practice Phone: 315-668-0413
Practice Fax:

1952817629 — MARIE S KARBOSKI
Practice Location Address:

3018 EAST AVE
CENTRAL SQUARE, NY
13036-2713

Practice Phone: 315-668-0422
Practice Fax: 315-668-0424

1871101576 — VISTA EYECARE, LLC
Practice Location Address:

3018 EAST AVE
CENTRAL SQUARE, NY
13036-2713

Practice Phone: 315-885-0764
Practice Fax:

1235966458 — NICOLE M BROADWELL
Practice Location Address:

3018 EAST AVE
CENTRAL SQUARE, NY
13036-2713

Practice Phone: 315-668-0422
Practice Fax:

1013115278 — MR. EDWARD MICU LMHC
Practice Location Address:

ONE VILLAGE SQUARE , 14-16 FLETCHER STREET - SUITE 5
CHELMSFORD, MA
01824-2713

Practice Phone: 978-201-3377
Practice Fax: 530-466-3377

1689629123 — DR. SITA M BOPPANA M.D.
Practice Location Address:

2460 N CENTRAL EXPY , SUITE 101
RICHARDSON, TX
75080-2713

Practice Phone: 972-644-1100
Practice Fax: 972-644-1107

Directions to “ OLESSIA XENIA BUTENKO OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.