Provider Demographics
NPI:1801880919
Name:WHITE, CHRISTINE DAYTON (OD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DAYTON
Last Name:WHITE
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 1:128 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:NY
Mailing Address - Zip Code:14414-1209
Mailing Address - Country:US
Mailing Address - Phone:585-226-3400
Mailing Address - Fax:585-226-3400
Practice Address - Street 1:128 GENESEE ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:NY
Practice Address - Zip Code:14414-1209
Practice Address - Country:US
Practice Address - Phone:585-226-3400
Practice Address - Fax:585-226-3400
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004025-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695405Medicaid
NY17579BMedicare ID - Type Unspecified
NY00695405Medicaid