Provider Demographics
NPI:1093860843
Name:UNIVERSITY OPHTHALMOLOGY SERVICES INC.
Entity Type:Organization
Organization Name:UNIVERSITY OPHTHALMOLOGY SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-834-0013
Mailing Address - Street 1:3540 SHERIDAN DR
Mailing Address - Street 2:STE140A
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226
Mailing Address - Country:US
Mailing Address - Phone:716-834-0013
Mailing Address - Fax:716-834-0081
Practice Address - Street 1:3580 SHERIDAN DR
Practice Address - Street 2:SUITE 115
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1645
Practice Address - Country:US
Practice Address - Phone:716-834-0013
Practice Address - Fax:716-834-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01731415Medicaid
NYF96982Medicare UPIN
NY01731415Medicaid