National Provider Identifier

Western New York Medical Practice, P.C.

Western New York Medical Practice, P.C. is listed in the NPPES registry with a primary specialty of Optician in Rochester, NY and a listed phone number of (585) 544-6680.

NPI 1205643400Rochester, NYOptician

Profile Overview

NPI
1205643400
Provider Type
Organization
Primary Specialty
Optician
Enumeration Date
December 12, 2024
Last Updated
December 12, 2024

Practice Location

  • 1338 E Ridge RD
  • Rochester, NY 14621-2018

Phone: (585) 544-6680

Mailing Address

  • 100 Kings Hwy S
  • Rochester, NY 14617-5504

Specialties

  • Optician (156FX1800X)
  • Eyewear Supplier (332H00000X)
Full Record
NPI
1205643400
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Western New York Medical Practice, P.C.
Mailing Street Address
100 Kings Hwy S
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14617-5504
Mailing Country
US
Practice Street Address
1338 E Ridge RD
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-2018
Practice Country
US
Practice Phone
(585) 544-6680
Enumeration Date
December 12, 2024
Last Updated
December 12, 2024
Authorized Official Last Name
Holder
Authorized Official First Name
Nichole
Authorized Official Middle Name
S
Authorized Official Title
Director - Payer Enrollment
Authorized Official Phone
(585) 922-0293
Organization Subpart
Yes
Parent Organization Name
WESTERN NEW YORK MEDICAL PRACTICE, P.C.
Parent Organization TIN
<UNAVAIL>
Taxonomy Group 2
193400000X Single Specialty Group
Certification Date
December 12, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Optician (156FX1800X), Eyewear Supplier (332H00000X)