Organization
DAVISON ROAD OPTICAL INC
Active
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
2731 MAIN ST, NEWFANE, NY 14108-1203
(716) 778-0926
(716) 778-0926
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000300233002
BC-BS
NY
01
—
0005901355
AETNA GROUP #
NY
01
—
1071
UNIVERA PIN #
NY
01
—
145817C
PREFFERED CARE
NY
01
—
149010
COLE
NY
01
—
330868
NVA
NY
01
—
NY3149
EYEMED LOCATION #
NY
01
—
OS0044759
INDEPENDENT HEALTH RX #
NY
Enumeration date
03/26/2007
Last updated
08/16/2011
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