Provider Demographics
NPI:1285157966
Name:DAVE, AVANI (OD, FAAO)
Entity type:Individual
Prefix:DR
First Name:AVANI
Middle Name:
Last Name:DAVE
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2102
Mailing Address - Country:US
Mailing Address - Phone:716-677-6500
Mailing Address - Fax:716-677-6507
Practice Address - Street 1:1176 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2102
Practice Address - Country:US
Practice Address - Phone:716-677-6500
Practice Address - Fax:716-677-6507
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5237152WC0802X, 152W00000X
NY8876TUV152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist