Healthcare Provider Details

I. General information

NPI: 1962696443
Provider Name (Legal Business Name): COUNCIL EYE CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4243 TRANSIT RD TRANSITOWN PLAZA
WILLIAMSVILLE NY
14221-7205
US

IV. Provider business mailing address

4243 TRANSIT RD TRANSITOWN PLAZA
WILLIAMSVILLE NY
14221-7205
US

V. Phone/Fax

Practice location:
  • Phone: 716-633-2440
  • Fax: 716-633-6109
Mailing address:
  • Phone: 716-633-2440
  • Fax: 716-633-6109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW R MYERS
Title or Position: PRESIDENT
Credential: O.D.
Phone: 716-633-2440