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General NPI Number Information
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NPI Number | 1962479949
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OPTICAL CORP
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 01/11/2008
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Provider Practice Location Address
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Address Line | 2469 STATE ROUTE 19 N
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City | WARSAW
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State | NY
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Zip | 14569-9336
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Country | US
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Telephone | 585-786-8505
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Fax | 585-786-8490
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Provider Business Mailing Address
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Address Line | 2469 STATE ROUTE 19 N
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City | WARSAW
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State | NY
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Zip | 14569-9336
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Country | US
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Telephone | 585-786-8505
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Fax | 585-786-8490
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. JENNIFER C. HUBER
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Credential |
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Telephone | 585-786-8505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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