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General NPI Number Information
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NPI Number | 1699986240
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Entity Type | Organization
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Legal Business Name | MARY E. VADAS, OD, LLC
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 02/29/2008
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Provider Practice Location Address
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Address Line | 2277 S UNION ST
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City | SPENCERPORT
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State | NY
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Zip | 14559-2225
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Country | US
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Telephone | 585-349-3300
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Fax | 585-349-3336
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Provider Business Mailing Address
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Address Line | 2277 S UNION ST
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City | SPENCERPORT
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State | NY
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Zip | 14559-2225
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Country | US
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Telephone | 585-349-3300
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Fax | 585-349-3336
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARY ELIZABETH VADAS
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Credential | O.D.
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Telephone | 585-349-3300
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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 |
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License Number State | NY
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