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General NPI Number Information
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NPI Number | 1396122032
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Entity Type | Organization
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Legal Business Name | LADOTA OPTOMETRY, PC
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 363 DELAWARE ST
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City | TONAWANDA
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State | NY
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Zip | 14150-3951
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Country | US
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Telephone | 716-695-2025
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Fax |
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Provider Business Mailing Address
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Address Line | 363 DELAWARE ST
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City | TONAWANDA
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State | NY
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Zip | 14150-3951
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Country | US
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Telephone | 716-695-2025
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Fax |
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Authorized Official
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Title or Position | ASSISTANT
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Name | MS. LAURIE E KEYES
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Credential |
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Telephone | 716-381-0698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | TUV006986
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License Number State | NY
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