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NPI Code Detail

MEDICARE: MARISSA RENEE SEIDER OD

MEDICARE:   MARISSA RENEE SEIDER  OD
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
1152W00000XOptometrist009849NY

General Provider Information

NPI Number : 1558048728
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA RENEE SEIDER OD
Provider Business Mailing Address
First Line : 3768 COOMER RD
Second Line :
City : NEWFANE
State : NY
Zip : 14108-9617
Country : US
Telephone Number : 716-343-3207
Fax Number :
Provider Business Practice Location Address
First Line : 2825 NIAGARA FALLS BLVD STE 130
Second Line :
City : AMHERST
State : NY
Zip : 14228-2021
Country : US
Telephone Number : 716-564-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2023
Last Update Date : 06/29/2023

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Directions to “ MARISSA RENEE SEIDER OD” Practice Location

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