National Provider Identifier
Ethan Boryszak, O.D.
Ethan Boryszak, O.D. is listed in the NPPES registry with a primary specialty of Optometrist in Lockport, NY and a listed phone number of (716) 631-3860.
Profile Overview
- NPI
- 1124060751
- Provider Type
- Individual
- Primary Specialty
- Optometrist
- Enumeration Date
- June 11, 2006
- Last Updated
- October 16, 2008
Practice Location
- 5683 S Transit RD
- Lockport, NY 14094-5844
Phone: (716) 631-3860
Specialties
- Optometrist (152W00000X)
Full Record
- NPI
- 1124060751
- Entity Type
- Individual
- Last Name
- Boryszak
- First Name
- Ethan
- Credential
- O.D.
- Mailing Street Address
- 5683 S Transit RD
- Mailing City
- Lockport
- Mailing State
- NY
- Mailing ZIP Code
- 14094-5844
- Mailing Country
- US
- Mailing Phone
- (716) 631-3860
- Practice Street Address
- 5683 S Transit RD
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-5844
- Practice Country
- US
- Practice Phone
- (716) 631-3860
- Enumeration Date
- June 11, 2006
- Last Updated
- October 16, 2008
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optometrist (152W00000X)
- Other Identifiers
- 1124060751 (NY, Univera), NY6999 (NY, Eye Med), 02748149 (NY)