Provider Demographics
NPI:1134308240
Name:KENMORE EYE CARE INC.
Entity Type:Organization
Organization Name:KENMORE EYE CARE INC.
Other - Org Name:AMHERST EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BURSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-688-8127
Mailing Address - Street 1:606 N FRENCH RD STE 7&8
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2108
Mailing Address - Country:US
Mailing Address - Phone:716-688-8127
Mailing Address - Fax:716-688-8227
Practice Address - Street 1:606 N FRENCH RD STE 7&8
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2108
Practice Address - Country:US
Practice Address - Phone:716-688-8127
Practice Address - Fax:716-688-8227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004496152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAA1666Medicare PIN
NYT88391Medicare UPIN