Healthcare Provider Details
I. General information
NPI: 1861782310
Provider Name (Legal Business Name): MICHAEL L VILARDO MD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2011
Last Update Date: 04/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4800 NORTH FRENCH ROAD
EAST AMHERST NY
14051-2178
US
IV. Provider business mailing address
4800 NORTH FRENCH ROAD
EAST AMHERST NY
14051-2178
US
V. Phone/Fax
- Phone: 716-688-0996
- Fax: 716-688-0997
- Phone: 716-688-0996
- Fax: 716-688-0997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 1896491 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
MICHAEL
L
VILARDO
Title or Position: OWNER
Credential: MD
Phone: 716-688-0996