Healthcare Provider Details

I. General information

NPI: 1982103032
Provider Name (Legal Business Name): 99EYE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 06/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 MONROE AVE
ROCHESTER NY
14618-1919
US

IV. Provider business mailing address

1924 MONROE AVE
ROCHESTER NY
14618-1919
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-7613
  • Fax: 585-473-9190
Mailing address:
  • Phone: 585-271-7613
  • Fax: 585-473-9190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDITH ANN ARCHER
Title or Position: OWNER/ OPTOMOTRIST
Credential: O.D.
Phone: 585-271-7613