| |
3171 Chili Ave, Suite 100, Rochester, NY 14624-5440 | |
(585) 889-9693 | |
(585) 889-3558 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 3171 Chili Ave, Rochester, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225251994 | NPI | - | NPPES |
00490088 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | VUT002921 (New York) | Secondary |
332H00000X | Eyewear Supplier | VUT002921 (New York) | Primary |
Mailing Address | Practice Location Address |
---|---|
3171 Chili Ave, Suite 100, Rochester, NY 14624-5440 Ph: (585) 889-9693 | 3171 Chili Ave, Suite 100, Rochester, NY 14624-5440 Ph: (585) 889-9693 |