Provider Demographics
NPI:1730342767
Name:BEYER, JILLIAN L (OD)
Entity type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:L
Last Name:BEYER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 BUFFALO ST.
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-5001
Mailing Address - Country:US
Mailing Address - Phone:716-649-1035
Mailing Address - Fax:716-646-3926
Practice Address - Street 1:6500 PORTER RD STE 2020
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-1529
Practice Address - Country:US
Practice Address - Phone:716-282-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007272152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist