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General NPI Number Information
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NPI Number | 1619451135
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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 | 09/20/2018
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 2000 EMPIRE BLVD STE 200
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City | WEBSTER
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State | NY
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Zip | 14580-1957
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Country | US
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Telephone | 585-671-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 601 ELMWOOD AVE OPTICAL SHOP
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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 | 585-275-0378
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Fax |
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Authorized Official
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Title or Position | INFORMATION ANALYST
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Name | SUSAN M OATMAN
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Credential |
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Telephone | 585-275-0378
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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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