National Provider Identifier

Jaime Larsen Kenny, OD

Jaime Larsen Kenny, OD is listed in the NPPES registry with a primary specialty of Optometrist in Webster, NY and a listed phone number of (585) 872-2200.

NPI 1154368736Webster, NYOptometrist

Profile Overview

NPI
1154368736
Provider Type
Individual
Primary Specialty
Optometrist
Enumeration Date
June 01, 2006
Last Updated
February 06, 2018

Practice Location

  • 1028 Ridge RD Ste 104
  • Empire Vision Centers
  • Webster, NY 14580-2973

Phone: (585) 872-2200

Mailing Address

  • 1028 Ridge RD
  • Ste 104
  • Webster, NY 14580-2975

Specialties

  • Optometrist (152W00000X)
Full Record
NPI
1154368736
Entity Type
Individual
Last Name
Kenny
First Name
Jaime
Middle Name
Larsen
Name Prefix
Dr.
Credential
OD
Provider Other Last Name
Van Fossan
Provider Other First Name
Jaime
Provider Other Middle Name
Larsen
Provider Other Name Prefix Text
Dr.
Provider Other Credential Text
OD
Provider Other Last Name Type Code
5
Mailing Street Address
1028 Ridge RD
Mailing Address Line 2
Ste 104
Mailing City
Webster
Mailing State
NY
Mailing ZIP Code
14580-2975
Mailing Country
US
Mailing Phone
(315) 445-7465
Mailing Fax
(315) 445-7675
Practice Street Address
1028 Ridge RD Ste 104
Practice Address Line 2
Empire Vision Centers
Practice City
Webster
Practice State
NY
Practice ZIP Code
14580-2973
Practice Country
US
Practice Phone
(585) 872-2200
Practice Fax
(585) 288-8998
Enumeration Date
June 01, 2006
Last Updated
February 06, 2018
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Optometrist (152W00000X)