Provider Demographics
NPI:1104865062
Name:INFINITY EYE OD PLLC
Entity Type:Organization
Organization Name:INFINITY EYE OD PLLC
Other - Org Name:CLARENCE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-668-2020
Mailing Address - Street 1:8560 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7460
Mailing Address - Country:US
Mailing Address - Phone:716-668-2020
Mailing Address - Fax:716-204-8639
Practice Address - Street 1:8560 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7460
Practice Address - Country:US
Practice Address - Phone:716-668-2020
Practice Address - Fax:716-204-8639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNY08450OtherVISION BENEFITS OF AMERIC
NY00030750401OtherUNIVERA HEALTHCARE
NY2409276OtherUNITED HEALTH CARE
NY2409276OtherUNITED HEALTH CARE
5152370001Medicare NSC