Provider Demographics
NPI:1922192889
Name:COATNEY, SHERI L (OD)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:COATNEY
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:P.O. BOX 280
Mailing Address - Street 2:
Mailing Address - City:ALLEGANY
Mailing Address - State:NY
Mailing Address - Zip Code:14706
Mailing Address - Country:US
Mailing Address - Phone:716-378-8563
Mailing Address - Fax:
Practice Address - Street 1:1979 MARCUS AVE STE 206
Practice Address - Street 2:
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:877-506-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT005579152W00000X
WI19171-875152W00000X
WA00001797152W00000X
FLTP0P50152W00000X
MI4901003120152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
650OtherDAVIS PANEL
NY003900633OtherWNYBCBS
NY00025361401OtherUNIVERA HEALTHCARE
NY01649476Medicaid