Provider Demographics
NPI:1164470019
Name:M S NAPOLEON MD PC
Entity Type:Organization
Organization Name:M S NAPOLEON MD PC
Other - Org Name:WAYNE REGIONAL EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARY SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPOLEON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-331-8921
Mailing Address - Street 1:1210 DRIVING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1057
Mailing Address - Country:US
Mailing Address - Phone:315-331-8921
Mailing Address - Fax:315-331-8231
Practice Address - Street 1:1210 DRIVING PARK AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1057
Practice Address - Country:US
Practice Address - Phone:315-331-8921
Practice Address - Fax:315-331-8231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01639716Medicaid
NY17547AMedicare ID - Type UnspecifiedGROUP ID
NY01639716Medicaid