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General NPI Number Information
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NPI Number | 1093741233
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Entity Type | Individual
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Provider Name | HAROLD JOHN ROBERTS OD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1260 LYELL AVE
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City | ROCHESTER
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State | NY
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Zip | 14606
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Country | US
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Telephone | 585-254-0193
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Fax |
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Provider Business Mailing Address
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Address Line | 5 CREST RD
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City | EAST ROCHESTER
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State | NY
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Zip | 14445-1631
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Country | US
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Telephone | 585-267-7552
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T002796
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License Number State | NY
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