Healthcare Provider Details

I. General information

NPI: 1881733939
Provider Name (Legal Business Name): VICKI J. MILLER-SAVARD & CARRIE Z. O'NEILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 DRIVING PARK AVE
NEWARK NY
14513-1050
US

IV. Provider business mailing address

1000 DRIVING PARK AVE
NEWARK NY
14513-1050
US

V. Phone/Fax

Practice location:
  • Phone: 315-331-5059
  • Fax: 315-331-5482
Mailing address:
  • Phone: 315-331-5059
  • Fax: 315-331-5482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberNOO5139
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberNOO5548
License Number StateNY

VIII. Authorized Official

Name: DR. CARRIE Z. O'NEILL
Title or Position: PARTNER
Credential: D.P.M.
Phone: 315-331-5059