Provider Demographics
NPI:1659865095
Name:AMABILE, AARON ANTHONY (OPTHALMIC DISPENSER)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:ANTHONY
Last Name:AMABILE
Suffix:
Gender:M
Credentials:OPTHALMIC DISPENSER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2064 SENECA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14210-2343
Mailing Address - Country:US
Mailing Address - Phone:716-822-1515
Mailing Address - Fax:
Practice Address - Street 1:2064 SENECA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-2343
Practice Address - Country:US
Practice Address - Phone:716-822-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009781-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician