MEDICARE: DR. DIANE LAKOMY CRESS 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
1	152W00000X	Optometrist	TUV005433-1	NY
2	152W00000X	Optometrist	0601002280	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NY5433	OTHER	NY	EYEMED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598766461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE LAKOMY CRESS OD

Provider Business Mailing Address
First Line	:	PO BOX 927
Second Line	:	C/O GEORGE OPTICAL CO.
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14302-0927
Country	:	US
Telephone Number	:	716-282-7377
Fax Number	:	716-282-7382

Provider Business Practice Location Address
First Line	:	1523 PINE AVE
Second Line	:	C/O GEORGE OPTICAL CO
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14301-2209
Country	:	US
Telephone Number	:	716-282-7377
Fax Number	:	716-282-7382

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/08/2007

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