| Legacy Vision Center Llc | |
|
2672 W Ridge Rd, Rochester, NY 14626-3054 | |
| (585) 245-0471 | |
| (585) 227-6963 |
| Full Name | Legacy Vision Center Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 2672 W Ridge Rd, Rochester, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891422382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Jason W Moore |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437177813 PECOS PAC ID: 3072508076 Enrollment ID: I20040419000996 |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Vision Center Llc 2672 W Ridge Rd, Rochester, NY 14626-3054 Ph: (585) 245-0471 | Legacy Vision Center Llc 2672 W Ridge Rd, Rochester, NY 14626-3054 Ph: (585) 245-0471 |
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