Healthcare Provider Details

I. General information

NPI: 1477034973
Provider Name (Legal Business Name): PARK SHER OPTICAL CO OF BUFFALO NY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5827 S TRANSIT RD
LOCKPORT NY
14094-6317
US

IV. Provider business mailing address

3035 GENESEE ST
CHEEKTOWAGA NY
14225-2661
US

V. Phone/Fax

Practice location:
  • Phone: 716-770-5970
  • Fax: 716-219-1176
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ROBERT JUDE JOBA
Title or Position: OD
Credential:
Phone: 716-947-2462