| Developmental Optometrist Pc | |
|
978 Colvin Blvd, Kenmore, NY 14217-2128 | |
| (716) 871-0074 | |
| (716) 878-8973 |
| Full Name | Developmental Optometrist Pc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 978 Colvin Blvd, Kenmore, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861885451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | TUV004506 (New York) | Primary |
| Provider Name | Mark J Gordon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1568420099 PECOS PAC ID: 2860520905 Enrollment ID: I20100511000040 |
| Mailing Address | Practice Location Address |
|---|---|
| Developmental Optometrist Pc 978 Colvin Blvd, Kenmore, NY 14217-2128 Ph: (716) 871-0074 | Developmental Optometrist Pc 978 Colvin Blvd, Kenmore, NY 14217-2128 Ph: (716) 871-0074 |
Dr. Francesco John Barbarossa, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 3750 Delaware Ave, Kenmore, NY 14217 Phone: 716-874-2455 Fax: 716-874-5775 | |
Melanie Metsa, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 227 Highland Pkwy, Kenmore, NY 14223 Phone: 716-873-4545 Fax: 716-896-2318 | |
Dr. Mark Jay Gordon, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 978 Colvin Blvd, Kenmore, NY 14217 Phone: 716-871-0074 Fax: 716-898-8973 |