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NPI Code Detail

MEDICARE: DR. WILLIAM KWIK O.D.

MEDICARE: DR. WILLIAM KWIK 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
1152W00000XOptometristVUT006383NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1123100CSOTHERNYPREFERRED CARE-HMO
2P017002559OTHERNYEXCELLUS,BC HMO,BCBS PPO(VENDOR ID)
3P010016383OTHERNYEXCELLUS/BLUE CHOICE HMO
43729902OTHERNYAETNA
5P050016383OTHERNYEXCELLUS/BLUE SHIELD PPO

General Provider Information

NPI Number : 1790753069
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM KWIK O.D.
Provider Business Mailing Address
First Line : 6421 W QUAKER ST
Second Line :
City : ORCHARD PARK
State : NY
Zip : 14127-2354
Country : US
Telephone Number : 585-281-0321
Fax Number : 585-486-1766
Provider Business Practice Location Address
First Line : 6421 W QUAKER ST
Second Line :
City : ORCHARD PARK
State : NY
Zip : 14127-2354
Country : US
Telephone Number : 716-662-4525
Fax Number : 716-662-4138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2006
Last Update Date : 10/11/2018

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