Organization
DAVISON ROAD OPTICAL, INC.
Active
Other names
NEWFANE FAMILY EYECARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENEVIEVE L. SNYDER (ADMINISTRATOR)
(716) 434-8063
Entity
Organization
Contact information
Practice address
2731 MAIN ST, NEWFANE, NY 14108-1203
(716) 778-0926
(716) 778-0926
Mailing address
500 DAVISON RD, LOCKPORT, NY 14094-4021
(716) 778-0926
(716) 778-0926
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00026473001
UNIVERA
NY
01
—
000300233002
BCBS PROVIDER ID
NY
01
—
0005901355
AETNA
NY
01
—
106166CS
PREFERRED CARE
NY
01
—
330867
NVA
NY
01
—
7212222
INDEPENDENT HEALTH
NY
01
—
NY3149
EYEMED
NY
Enumeration date
04/09/2007
Last updated
10/29/2010
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