Provider Demographics
NPI:1720232598
Name:MICHAELS, MONICA M (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:M
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 GREY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2129
Mailing Address - Country:US
Mailing Address - Phone:716-652-8404
Mailing Address - Fax:716-652-6646
Practice Address - Street 1:110 GREY ST
Practice Address - Street 2:SUITE B
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2129
Practice Address - Country:US
Practice Address - Phone:716-652-8404
Practice Address - Fax:716-652-6646
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005405156FC0801X, 156FX1800X
NY003706171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician