Provider Demographics
NPI:1508076076
Name:NAEDELE, CHRISTOPHER W (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:W
Last Name:NAEDELE
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 115
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057-0115
Mailing Address - Country:US
Mailing Address - Phone:716-337-3784
Mailing Address - Fax:716-893-0633
Practice Address - Street 1:2507 HARLEM RD
Practice Address - Street 2:902 MAIN ST.
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-4527
Practice Address - Country:US
Practice Address - Phone:716-893-0633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008127-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician