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General NPI Number Information
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NPI Number | 1225433808
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Entity Type | Organization
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Legal Business Name | SYDNEY-ROSE, INC
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Dates
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Enumeration Date | 10/25/2014
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 1579 MAIN ST
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-7838
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Country | US
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Telephone | 845-635-3700
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Fax | 845-635-8317
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Provider Business Mailing Address
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Address Line | PO BOX 685
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-0685
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Country | US
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Telephone | 845-635-3700
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Fax | 845-635-8317
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MICHAEL FRAYLER
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Credential |
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Telephone | 845-635-3700
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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 | TUV007678-1
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License Number State | NY
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