Healthcare Provider Details

I. General information

NPI: 1609847011
Provider Name (Legal Business Name): DANIELLE LYNNE JAMES O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 09/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4235 VETERAN DR
GENESEO NY
14454-9433
US

IV. Provider business mailing address

6318 BENTLEY DR
VICTOR NY
14564-9562
US

V. Phone/Fax

Practice location:
  • Phone: 585-243-4004
  • Fax: 585-243-4009
Mailing address:
  • Phone: 732-239-9094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV 006881-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: