MEDICARE: DR. MICHAEL JOSEPH CIERI O.D.

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	TUV005388	NY
2	152W00000X	Optometrist	VUT005388	NY

General Provider Information

NPI Number	:	1700872322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL JOSEPH CIERI O.D.

Provider Business Mailing Address
First Line	:	3465 CALVANO DR
Second Line	:
City	:	GRAND ISLAND
State	:	NY
Zip	:	14072-1049
Country	:	US
Telephone Number	:	716-774-8319
Fax Number	:	716-774-8319

Provider Business Practice Location Address
First Line	:	444 PAYNE AVE
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-6902
Country	:	US
Telephone Number	:	716-693-1280
Fax Number	:

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	10/22/2016

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