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General NPI Number Information
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NPI Number | 1295808079
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Entity Type | Organization
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Legal Business Name | SCHUTZ OPTICAL CO INC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 3192 WALDEN AVE
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City | DEPEW
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State | NY
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Zip | 14043-2846
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Country | US
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Telephone | 716-684-4950
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Fax | 716-684-3036
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Provider Business Mailing Address
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Address Line | 8425 BOSTON STATE RD
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City | BOSTON
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State | NY
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Zip | 14025-9633
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Country | US
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Telephone | 716-941-5340
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Fax | 716-941-9281
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES JOSEPH HORNBERGER JR.
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Credential | OD
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Telephone | 716-941-5585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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