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General NPI Number Information
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NPI Number | 1225491541
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Entity Type | Individual
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Provider Name | ANNA NICOTERA
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Gender | Female
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 04/04/2016
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Provider Practice Location Address
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Address Line | 2672 W RIDGE RD
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City | GREECE
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State | NY
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Zip | 14626-3054
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Country | US
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Telephone | 585-245-0471
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Fax | 585-227-3191
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Provider Business Mailing Address
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Address Line | 2672 W RIDGE RD
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City | GREECE
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State | NY
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Zip | 14626-3054
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Country | US
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Telephone | 585-245-0471
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Fax | 585-227-3191
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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