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General NPI Number Information
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NPI Number | 1619988052
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Entity Type | Organization
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Legal Business Name | ROME OPTICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 110 E CHESTNUT ST
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City | ROME
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State | NY
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Zip | 13440
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Country | US
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Telephone | 315-337-8802
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E CHESTNUT ST
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City | ROME
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State | NY
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Zip | 13440
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Country | US
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Telephone | 315-337-8802
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. LAWRENCE L RIOLO JR.
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Credential |
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Telephone | 315-337-8802
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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 | 3869
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License Number State | NY
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