Provider Demographics
NPI:1750860227
Name:HINDS, JACQUELYN PAIGE (OD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELYN
Middle Name:PAIGE
Last Name:HINDS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:5978 VERMONT HILL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WALES
Mailing Address - State:NY
Mailing Address - Zip Code:14139-9731
Mailing Address - Country:US
Mailing Address - Phone:716-341-4401
Mailing Address - Fax:
Practice Address - Street 1:3768 SENECA ST
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3433
Practice Address - Country:US
Practice Address - Phone:716-674-8300
Practice Address - Fax:716-674-8302
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY008858152WC0802X, 152WL0500X, 152WP0200X, 152WV0400X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy