MEDICARE: TOWN PARK OPTICAL

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	156FX1800X	Optician	2306	NY

General Provider Information

NPI Number	:	1982691101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN PARK OPTICAL

Provider Business Mailing Address
First Line	:	2507 HARLEM RD
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14225-4527
Country	:	US
Telephone Number	:	716-893-0633
Fax Number	:	716-893-0633

Provider Business Practice Location Address
First Line	:	2507 HARLEM RD
Second Line	:
City	:	CHEEKTOWAGA
State	:	NY
Zip	:	14225-4527
Country	:	US
Telephone Number	:	716-893-0633
Fax Number	:	716-893-0633

Authorized Official
Title or Position	:	OPTICIAN OWNER
Name	:	MR. THOMAS J STEPKA
Credential	:
Telephone Number	:	716-893-0633

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	08/22/2020

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Directions to “TOWN PARK OPTICAL ” Practice Location

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