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General NPI Number Information
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NPI Number | 1386618999
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Entity Type | Individual
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Provider Name | BRAD W PERRY OD
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 121 MIRACLE MILE DR
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City | ROCHESTER
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State | NY
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Zip | 14623-5864
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Country | US
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Telephone | 585-427-7960
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Fax | 585-427-0451
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Provider Business Mailing Address
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Address Line | 121 MIRACLE MILE DR
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City | ROCHESTER
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State | NY
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Zip | 14623-5864
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Country | US
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Telephone | 585-427-7960
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Fax | 585-427-0451
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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 | T006224
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT006224
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License Number State | NY
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