Provider Demographics
NPI:1952915589
Name:WHELAN, KAYLA M (OD)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:M
Last Name:WHELAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:151 BUFFALO AVE APT 211
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14303-1200
Mailing Address - Country:US
Mailing Address - Phone:716-284-9449
Mailing Address - Fax:
Practice Address - Street 1:1284 DRYDEN RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-8795
Practice Address - Country:US
Practice Address - Phone:607-257-1066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRT00-9222152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist