Provider Demographics
NPI:1598766461
Name:CRESS, DIANE LAKOMY (OD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:LAKOMY
Last Name:CRESS
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:PO BOX 927
Mailing Address - Street 2:C/O GEORGE OPTICAL CO.
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14302-0927
Mailing Address - Country:US
Mailing Address - Phone:716-282-7377
Mailing Address - Fax:716-282-7382
Practice Address - Street 1:1523 PINE AVE
Practice Address - Street 2:C/O GEORGE OPTICAL CO
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-2209
Practice Address - Country:US
Practice Address - Phone:716-282-7377
Practice Address - Fax:716-282-7382
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005433-1152W00000X
VA0601002280152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNY5433OtherEYEMED
NY01527095Medicaid
NY1A0588Medicare ID - Type Unspecified
U46761Medicare UPIN