Provider Demographics
NPI:1053200808
Name:ROTTNER, CHARLES CHRISTIAN (OD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:CHRISTIAN
Last Name:ROTTNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8421 HIDDEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-2020
Mailing Address - Country:US
Mailing Address - Phone:716-908-9058
Mailing Address - Fax:
Practice Address - Street 1:6500 PORTER RD STE 2020
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1529
Practice Address - Country:US
Practice Address - Phone:716-282-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-28
Last Update Date:2025-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011189152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist