Organization
RIVERSIDE SPECS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WILLIAM RADAU (OWNER/OPTICIAN)
(716) 362-0800
Entity
Organization
Contact information
Practice address
742 TONAWANDA ST, BUFFALO, NY 14207-2145
(716) 362-0800
(716) 362-0801
Mailing address
742 TONAWANDA ST, BUFFALO, NY 14207-2145
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
7296
NY
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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