Provider Demographics
NPI:1720604408
Name:SUTTON, KATELYN C (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:C
Last Name:SUTTON
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8124 TRANSIT RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2806
Mailing Address - Country:US
Mailing Address - Phone:716-220-7700
Mailing Address - Fax:
Practice Address - Street 1:8124 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-2806
Practice Address - Country:US
Practice Address - Phone:716-220-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician