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General NPI Number Information
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NPI Number | 1932447166
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Entity Type | Organization
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Legal Business Name | REGINA M. DEVITO, O.D., P.C.
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 6011 WESTCLIFFE RD
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City | JAMESVILLE
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State | NY
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Zip | 13078-9310
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Country | US
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Telephone | 315-446-1685
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Fax |
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Provider Business Mailing Address
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Address Line | 6011 WESTCLIFFE RD
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City | JAMESVILLE
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State | NY
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Zip | 13078-9310
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Country | US
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Telephone | 315-446-1685
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. REGINA M DEVITO
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Credential |
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Telephone | 315-440-8168
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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 | TUV005610
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License Number State | NY
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