Provider Demographics
NPI:1477034973
Name:PARK SHER OPTICAL CO OF BUFFALO NY INC
Entity Type:Organization
Organization Name:PARK SHER OPTICAL CO OF BUFFALO NY INC
Other - Org Name:YOUR LOCAL OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-770-5970
Mailing Address - Street 1:7 DIANE CT
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4933
Mailing Address - Country:US
Mailing Address - Phone:716-713-2358
Mailing Address - Fax:716-219-1176
Practice Address - Street 1:5827 S TRANSIT RD
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-6317
Practice Address - Country:US
Practice Address - Phone:716-770-5970
Practice Address - Fax:716-219-1176
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARK-SHER OPTICAL COMPANY OF BUFFALO, NEW YORK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-23
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty