Provider Demographics
NPI:1366537532
Name:BIELINSKI, JOHN (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:BIELINSKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 SHARON DRIVE
Mailing Address - Street 2:
Mailing Address - City:W. SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224
Mailing Address - Country:US
Mailing Address - Phone:716-675-0507
Mailing Address - Fax:
Practice Address - Street 1:3861 SOUTH PARK AVE.
Practice Address - Street 2:
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219
Practice Address - Country:US
Practice Address - Phone:716-823-6093
Practice Address - Fax:716-362-0913
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003165152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000390186004OtherBC/BS OF WESTERN NY
NY00030863501OtherUNIVERA PLUS MED, CHP
NY00603732Medicaid
NYNY3156OtherEYEMED
NY000390186004OtherBC/BS OF WESTERN NY
NY00030863501OtherUNIVERA PLUS MED, CHP