Provider Demographics
NPI:1558920413
Name:BARTELS, MADELINE ROSE (OD)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:ROSE
Last Name:BARTELS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 KAYMAR DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-3466
Mailing Address - Country:US
Mailing Address - Phone:716-909-1258
Mailing Address - Fax:
Practice Address - Street 1:2126 NIAGARA FALLS BLVD
Practice Address - Street 2:
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14150-4700
Practice Address - Country:US
Practice Address - Phone:716-693-4606
Practice Address - Fax:716-693-7329
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008940152WC0802X
NYTUV008940-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management