Healthcare Provider Details

I. General information

NPI: 1396780615
Provider Name (Legal Business Name): MICHELE ANN LAGANA O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 PARTRIDGE HL
HONEOYE FALLS NY
14472-9701
US

IV. Provider business mailing address

79 PARTRIDGE HL
HONEOYE FALLS NY
14472-9701
US

V. Phone/Fax

Practice location:
  • Phone: 585-624-5457
  • Fax:
Mailing address:
  • Phone: 585-719-7717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberVUT005364
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: