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General NPI Number Information
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NPI Number | 1568634350
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Entity Type | Organization
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Legal Business Name | COUNCIL OPTICIANS OF EAST AURORA
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 323 MAIN ST
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City | EAST AURORA
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State | NY
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Zip | 14052-1636
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Country | US
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Telephone | 716-655-3225
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Fax |
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Provider Business Mailing Address
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Address Line | 323 MAIN ST
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City | EAST AURORA
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State | NY
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Zip | 14052-1636
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Country | US
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Telephone | 716-655-3225
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. FRANCIS ANTHONY TRZEPKOWSKI
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Credential | OD
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Telephone | 716-655-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | T4727
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License Number State | NY
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