Healthcare Provider Details

I. General information

NPI: 1497771646
Provider Name (Legal Business Name): NEURO-OPHTHALMOLOGY CONSULTANTS OF ROCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CANAL VIEW BLVD SUITE 102
ROCHESTER NY
14623-2852
US

IV. Provider business mailing address

200 CANAL VIEW BLVD SUITE 102
ROCHESTER NY
14623-2852
US

V. Phone/Fax

Practice location:
  • Phone: 585-461-5330
  • Fax: 585-461-9895
Mailing address:
  • Phone: 585-461-5330
  • Fax: 585-461-9895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID N. SMITH
Title or Position: OWNER
Credential: M.D.
Phone: 585-461-5330