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Individual

DR. CHARLES M SANGEORGE II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
4255 MCKINLEY PKWY, INSIDE WAL-MART VISION CENTER, HAMBURG, NY 14075-1005
(716) 646-0564
(716) 646-0571
Mailing address
4255 MCKINLEY PKWY, INSIDE WAL-MART VISION CENTER, HAMBURG, NY 14075-1005
(716) 646-0564
(716) 646-0571

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV006278
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000390184002
COMMUNITY BLUE
NY
01
000390184004
COMMUNITY BLUE
NY
01
141345
COLE MANAGED VISION
NY
01
17207
SPECTERA
NY
01
50527
DAVIS VISION
NY
01
919920
BLOCK VISION
NY
01
988665
HIGHMARK BC & BS
NY
01
NY3441
EYEMED
NY
Enumeration date
06/28/2005
Last updated
01/11/2008
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