Healthcare Provider Details

I. General information

NPI: 1669439725
Provider Name (Legal Business Name): VISION ASSOCIATES OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 04/21/2021
Certification Date: 04/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 LYELL AVE
ROCHESTER NY
14606-2040
US

IV. Provider business mailing address

1240 LYELL AVE
ROCHESTER NY
14606-2026
US

V. Phone/Fax

Practice location:
  • Phone: 585-254-0022
  • Fax: 585-254-0132
Mailing address:
  • Phone: 585-254-0193
  • Fax: 585-254-2044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK C. HO
Title or Position: PRESIDENT
Credential:
Phone: 585-254-0020