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General NPI Number Information
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NPI Number | 1669452009
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Entity Type | Individual
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Provider Name | SHANNON L ROSENSWIE OD
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Gender | Female
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 25 E MAIN ST
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City | SPRINGVILLE
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State | NY
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Zip | 14141-1244
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Country | US
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Telephone | 716-592-3322
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Fax | 716-592-3311
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Provider Business Mailing Address
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Address Line | 25 E MAIN ST
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City | SPRINGVILLE
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State | NY
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Zip | 14141-1244
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Country | US
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Telephone | 716-592-3322
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Fax | 716-592-3311
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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 | TUV-006423-1
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License Number State | NY
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