MEDICARE: DR. DAVID L SHAFF 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	TUV003038	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
14	410043022	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	161168030	OTHER		UNITED HEALTH CARE
2	00091163900	OTHER		HEALTH NOW
3	161168030	OTHER		EMPIRE UHC EMPIRE
4	101433CS	OTHER	NY	PREFERRED CARE
5	161168030	OTHER		SIDNEY HILLMAN
6	161168030	OTHER		WORKERS COMP
7	P010003038	OTHER	NY	BLUE CHOICE
8	161168030	OTHER		DOCTORS HEALTH PLAN POMCO
9	P010003038	OTHER		MONROE PLAN BL CH OPT CHI
10	161168030	OTHER		TRICARE
11	P010003038	OTHER		BCBS EXCELLUS
12	161168030	OTHER		GHI GROUP HEALTH INCORPOR
13	7700447	OTHER		MVP SELECT CARE
15	101933CS	OTHER		PREFERRED CARE OPTION

General Provider Information

NPI Number	:	1407824261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID L SHAFF OD

Provider Business Mailing Address
First Line	:	533 W COMMERCIAL ST
Second Line	:
City	:	EAST ROCHESTER
State	:	NY
Zip	:	14445-2276
Country	:	US
Telephone Number	:	585-586-6882
Fax Number	:

Provider Business Practice Location Address
First Line	:	533 W COMMERCIAL ST
Second Line	:
City	:	EAST ROCHESTER
State	:	NY
Zip	:	14445-2276
Country	:	US
Telephone Number	:	585-586-6882
Fax Number	:

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	05/02/2011

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