National Provider Identifier
Michelle L Damico
Michelle L Damico is listed in the NPPES registry with a primary specialty of Optician in Brockport, NY and a listed phone number of (585) 637-3905.
Profile Overview
- NPI
- 1093380768
- Provider Type
- Individual
- Primary Specialty
- Optician
- Enumeration Date
- May 25, 2021
- Last Updated
- May 25, 2021
Practice Location
- 300 West Ave
- Brockport, NY 14420-1118
Phone: (585) 637-3905
Mailing Address
- 8181 Sackett RD
- Bergen, NY 14416-9350
Specialties
- Optician (156FX1800X)
Full Record
- NPI
- 1093380768
- Entity Type
- Individual
- Last Name
- Damico
- First Name
- Michelle
- Middle Name
- L
- Mailing Street Address
- 8181 Sackett RD
- Mailing City
- Bergen
- Mailing State
- NY
- Mailing ZIP Code
- 14416-9350
- Mailing Country
- US
- Mailing Phone
- (585) 301-1746
- Practice Street Address
- 300 West Ave
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420-1118
- Practice Country
- US
- Practice Phone
- (585) 637-3905
- Enumeration Date
- May 25, 2021
- Last Updated
- May 25, 2021
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- May 25, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optician (156FX1800X)