=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770530032
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET KAY ROSS-COMSTOCK OD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2006
-----------------------------------------------------
Last Update Date | 01/04/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 91 COOPER RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14617-3003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-266-0280
-----------------------------------------------------
Fax | 585-467-0927
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 91 COOPER RD
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14617-3003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-266-0280
-----------------------------------------------------
Fax | 585-467-0927
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | TUV0052791
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------