MEDICARE: DR. ING-CHYONG CHEN-RAWSON 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	VUT005354	NY

General Provider Information

NPI Number	:	1942285903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ING-CHYONG CHEN-RAWSON OD

Provider Business Mailing Address
First Line	:	1865 MAPLE RD
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-2734
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1865 MAPLE RD
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-2734
Country	:	US
Telephone Number	:	716-632-4877
Fax Number	:

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	03/23/2010

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