Provider Demographics
NPI:1346413952
Name:COUNCIL OPTICIANS OF HAMBURG, INC.
Entity Type:Organization
Organization Name:COUNCIL OPTICIANS OF HAMBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:TRZEPKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-648-5761
Mailing Address - Street 1:6000 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-3758
Mailing Address - Country:US
Mailing Address - Phone:716-648-5761
Mailing Address - Fax:716-648-4044
Practice Address - Street 1:6000 S PARK AVE
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-3758
Practice Address - Country:US
Practice Address - Phone:716-648-5761
Practice Address - Fax:716-648-4044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT4727332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier