Basic Information
| Provider Information | |||||||||
| NPI: | 1689767931 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROTHSCHILD | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | DAVID | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 57 PRESTONWOOD LN | ||||||||
| Address2: | |||||||||
| City: | EAST AMHERST | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140511685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7164797467 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4934 TRANSIT RD | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | DEPEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140434625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166681484 | ||||||||
| FaxNumber: | 7166681545 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2006 | ||||||||
| LastUpdateDate: | 06/03/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | TUV004348 | NY | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.