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General NPI Number Information
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NPI Number | 1144366147
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Entity Type | Organization
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Legal Business Name | SIDNEY HILLMAN HEALTH CNTR OF ROCHESTER
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 750 EAST AVE SUITE 2
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City | ROCHESTER
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State | NY
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Zip | 14607-2100
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Country | US
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Telephone | 585-271-1911
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Fax | 585-442-7216
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Provider Business Mailing Address
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Address Line | 750 EAST AVE SUITE 2
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City | ROCHESTER
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State | NY
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Zip | 14607-2100
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Country | US
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Telephone | 585-271-1911
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Fax | 585-442-7216
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Authorized Official
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Title or Position | MANAGING OPTICIAN
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Name | MR. MARK ANDREW SIDEBOTHAM
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Credential |
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Telephone | 585-271-1911
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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 | C003607-1
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License Number State | NY
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