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General NPI Number Information
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NPI Number | 1578276523
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Entity Type | Organization
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Legal Business Name | OPTOMETRIC VISION CARE PLLC
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 2126 NIAGARA FALLS BLVD
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City | TONAWANDA
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State | NY
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Zip | 14150-4700
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Country | US
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Telephone | 716-693-4606
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Fax | 716-693-7329
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Provider Business Mailing Address
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Address Line | 2126 NIAGARA FALLS BLVD
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City | TONAWANDA
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State | NY
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Zip | 14150-4700
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Country | US
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Telephone | 716-693-4606
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Fax | 716-693-7329
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Authorized Official
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Title or Position | OPTOMETRIST / MEMBER
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Name | MADELINE BARTELS
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Credential | OD
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Telephone | 716-693-4606
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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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