Provider Demographics
NPI:1053751560
Name:DELPRINCE, KATIE LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:LYNN
Last Name:DELPRINCE
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 1:980 W MAPLE COURT
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059
Mailing Address - Country:US
Mailing Address - Phone:716-652-0870
Mailing Address - Fax:716-652-2071
Practice Address - Street 1:980 W MAPLE COURT
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:NY
Practice Address - Zip Code:14059
Practice Address - Country:US
Practice Address - Phone:716-652-0870
Practice Address - Fax:716-652-2071
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV008029152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist