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General NPI Number Information
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NPI Number | 1568639201
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Entity Type | Organization
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Legal Business Name | CIRCLE OPTICAL
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 26 AREND AVE
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5102
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Country | US
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Telephone | 716-626-5647
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Fax | 716-626-5647
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Provider Business Mailing Address
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Address Line | 26 AREND AVE
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-5102
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Country | US
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Telephone | 716-626-5647
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Fax | 716-626-5647
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MATTHEW E SENDKER
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Credential | O.D.
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Telephone | 716-626-5647
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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 | NY4873
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License Number State | NY
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