Provider Demographics
NPI:1922452630
Name:EYE MAC OPTOMETRISTS
Entity Type:Organization
Organization Name:EYE MAC OPTOMETRISTS
Other - Org Name:INSIGHT EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:K
Authorized Official - Last Name:MACLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-824-1320
Mailing Address - Street 1:6053 CORINNE LN
Mailing Address - Street 2:
Mailing Address - City:CLARENCE CENTER
Mailing Address - State:NY
Mailing Address - Zip Code:14032-9510
Mailing Address - Country:US
Mailing Address - Phone:716-824-1320
Mailing Address - Fax:716-822-3735
Practice Address - Street 1:8070 TRANSIT RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4116
Practice Address - Country:US
Practice Address - Phone:716-631-3860
Practice Address - Fax:716-631-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04023841Medicaid
NYJ100049813OtherMEDICARE PTAN