Healthcare Provider Details

I. General information

NPI: 1316948714
Provider Name (Legal Business Name): MICHAEL L VILARDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 N FRENCH RD SUITE 4
EAST AMHERST NY
14051-2178
US

IV. Provider business mailing address

4800 N FRENCH RD
EAST AMHERST NY
14051-2178
US

V. Phone/Fax

Practice location:
  • Phone: 716-688-0996
  • Fax: 716-688-0997
Mailing address:
  • Phone: 716-688-0996
  • Fax: 716-896-2318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number1896491
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: