Davison Road Optical, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DAVISON ROAD OPTICAL, INC.

Doing business as

Newfane Family Eyecare

Practice address

2731 Main St
Newfane, NY 14108-1203

Phone

(716) 778-0926

Fax

(716) 778-0926

NPI assigned

Apr 9, 2007

Last updated

Oct 29, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Genevieve L. Snyder

Title

Administrator

Phone

(716) 434-8063

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• NEWFANE FAMILY EYECARE Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Davison Road Optical, Inc.

  • Optometrist
  • Lockport, NY
  • NPI 1326161035

  O20040528000450

  Same enrollment

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathryn Gahagan, O.D.

  • Optometrist
  • Lockport, NY
  • NPI 1124431739
  NPD
• Duane Snyder, OD

  • Optometrist
  • Lockport, NY
  • NPI 1346242955
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1508989211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DAVISON RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140944021",
            "telephone_number": "716-778-0926",
            "fax_number": "716-778-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 MAIN ST",
            "city": "NEWFANE",
            "state": "NY",
            "postal_code": "141081203",
            "telephone_number": "716-778-0926",
            "fax_number": "716-778-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVISON ROAD OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "GENEVIEVE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "716-434-8063",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "330867",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "NY3149",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026473001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "7212222",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "106166CS",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "000300233002",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005901355",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEWFANE FAMILY EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yong Baek CHI, M.D.
• Harnath Balendra Clerk, MD
• Christopher Thomas Connolly, RPH
• David Allan Czachorowski, RPH.
• Davison Road Optical Inc (Newfane Family Eyecare)
• Catherine Demjanenko, PT
• Kimberly Abigail Ebanks
• Jill M Ector, FNP-BC
• Farzana Habib (Newfane OB-GYN)
• Michael A Gray, RPA-C

• Optometrist in Newfane, NY
• Providers in Newfane, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.