MEDICARE: DR. LEE J BUTTAGGI OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TUV0046491	NY

General Provider Information

NPI Number	:	1356322044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEE J BUTTAGGI OD

Provider Business Mailing Address
First Line	:	2300 BUFFALO RD
Second Line	:	BLDG 700
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1360
Country	:	US
Telephone Number	:	585-328-0153
Fax Number	:	585-328-0158

Provider Business Practice Location Address
First Line	:	2300 BUFFALO RD
Second Line	:	BLDG 700
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1360
Country	:	US
Telephone Number	:	585-328-0153
Fax Number	:	585-328-0158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	10/27/2009

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