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General NPI Number Information
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NPI Number | 1982715686
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Entity Type | Organization
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Legal Business Name | LPEC MEDICAL EYE CARE PLLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 500 ERIE ST S
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City | MEDINA
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State | NY
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Zip | 14103-1010
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Country | US
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Telephone | 585-798-2020
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Fax | 585-798-3365
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Provider Business Mailing Address
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Address Line | 500 ERIE ST SOUTH
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City | MEDINA
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State | NY
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Zip | 14103-1010
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Country | US
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Telephone | 585-798-2020
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Fax | 585-798-3365
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ELAINE R WATTS
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Credential |
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Telephone | 585-798-2020
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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 | 120403
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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