| NPI | 1053464222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH POVEROMO Owner 716-542-2110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician (Licence: NY NY5194) |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |