Provider Demographics
NPI:1649943598
Name:MARWOOD, KELSEY AMBER (OD)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:AMBER
Last Name:MARWOOD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 EASTVIEW MALL
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1032
Mailing Address - Country:US
Mailing Address - Phone:585-425-7400
Mailing Address - Fax:585-425-2818
Practice Address - Street 1:307 EASTVIEW MALL
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1017
Practice Address - Country:US
Practice Address - Phone:585-425-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV009412-01152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist