Healthcare Provider Details

I. General information

NPI: 1750611414
Provider Name (Legal Business Name): WAYLAND MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 12/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 N MAIN ST
WAYLAND NY
14572-1031
US

IV. Provider business mailing address

7 N MAIN ST
WAYLAND NY
14572-1031
US

V. Phone/Fax

Practice location:
  • Phone: 585-728-9890
  • Fax: 585-728-5188
Mailing address:
  • Phone: 585-728-9890
  • Fax: 585-728-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBORAH R. SCHROEDL
Title or Position: PRESIDENT
Credential:
Phone: 585-728-9890