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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