MEDICARE: MR. CHRISTOPHER W NAEDELE OPTICIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	008127-1	NY

General Provider Information

NPI Number	:	1508076076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER W NAEDELE OPTICIAN

Provider Business Mailing Address
First Line	:	PO BOX 115
Second Line	:
City	:	EDEN
State	:	NY
Zip	:	14057-0115
Country	:	US
Telephone Number	:	716-337-3784
Fax Number	:	716-893-0633

Provider Business Practice Location Address
First Line	:	2507 HARLEM RD
Second Line	:	902 MAIN ST.
City	:	BUFFALO
State	:	NY
Zip	:	14225-4527
Country	:	US
Telephone Number	:	716-893-0633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	07/08/2007

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