Provider Demographics
NPI:1134697089
Name:WESTERN NEW YORK FAMILY EYECARE LLC
Entity Type:Organization
Organization Name:WESTERN NEW YORK FAMILY EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CAMPESE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-462-8519
Mailing Address - Street 1:4960 TRANSIT RD STE 1
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-4655
Mailing Address - Country:US
Mailing Address - Phone:716-462-8519
Mailing Address - Fax:
Practice Address - Street 1:4960 TRANSIT ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4655
Practice Address - Country:US
Practice Address - Phone:716-462-8519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty