Provider Demographics
NPI:1689919433
Name:DANIEL BRUNENAVS OD PLLC
Entity Type:Organization
Organization Name:DANIEL BRUNENAVS OD PLLC
Other - Org Name:CHADWICK BAY VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNENAVS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-366-4383
Mailing Address - Street 1:55 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2225
Mailing Address - Country:US
Mailing Address - Phone:716-366-4383
Mailing Address - Fax:716-366-8715
Practice Address - Street 1:55 E 4TH ST
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2225
Practice Address - Country:US
Practice Address - Phone:716-366-4383
Practice Address - Fax:716-366-8715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 006135152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty