Provider Demographics
NPI:1780235663
Name:EYE CARE PROFESSIONALS OF WESTERN NEW YORK LLP
Entity type:Organization
Organization Name:EYE CARE PROFESSIONALS OF WESTERN NEW YORK LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:716-833-2020
Mailing Address - Street 1:5500 MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6737
Mailing Address - Country:US
Mailing Address - Phone:716-833-2020
Mailing Address - Fax:716-833-3854
Practice Address - Street 1:5500 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6737
Practice Address - Country:US
Practice Address - Phone:716-833-2020
Practice Address - Fax:716-833-3854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02342469Medicaid
NY02399493Medicaid
NY04371371Medicaid
NY01089101Medicaid
NY00885323Medicaid
NY00885272Medicaid