Healthcare Provider Details

I. General information

NPI: 1134391725
Provider Name (Legal Business Name): VISION CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2008
Last Update Date: 12/19/2018
Certification Date:
Deactivation Date: 07/11/2008
Reactivation Date: 12/19/2018

III. Provider practice location address

2126 NIAGARA FALLS BLVD
TONAWANDA NY
14150-4700
US

IV. Provider business mailing address

501 KAYMAR DR
AMHERST NY
14228-3466
US

V. Phone/Fax

Practice location:
  • Phone: 716-693-4606
  • Fax: 716-693-7329
Mailing address:
  • Phone: 716-693-4606
  • Fax: 716-693-7329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV004096-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberTUV004096-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberTUV004096-1
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID P BARTELS
Title or Position: OWNER OPTOMETRIST
Credential: OD
Phone: 716-693-4606