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General NPI Number Information
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NPI Number | 1124744735
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Entity Type | Organization
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Legal Business Name | STRONG OPTICAL SHOP
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 500 CLINTON AVE S STE 104
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City | ROCHESTER
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State | NY
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Zip | 14620-1105
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Country | US
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Telephone | 585-727-9034
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Fax |
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Provider Business Mailing Address
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Address Line | 601 ELMWOOD AVE BOX 278884
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-727-9034
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Fax |
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Authorized Official
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Title or Position | SR DIRECTOR OF FINANCE, CHIEF BUDGE
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Name | JILL M HETTERICH
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Credential |
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Telephone | 585-756-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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