Healthcare Provider Details

I. General information

NPI: 1871551374
Provider Name (Legal Business Name): STEVEN FREDERICK HICKEY OPTHALMIC DISPENSER
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 LYELL AVE
ROCHESTER NY
14606-2040
US

IV. Provider business mailing address

20 HUNTERS DR N
FAIRPORT NY
14450-8603
US

V. Phone/Fax

Practice location:
  • Phone: 585-254-0029
  • Fax:
Mailing address:
  • Phone: 585-377-0914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License NumberC004786-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberC004786-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: