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NPI Code Detail

MEDICARE: GENESEO FAMILY EYE CARE, LLC

MEDICARE: GENESEO FAMILY EYE CARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristTUV005268NY

General Provider Information

NPI Number : 1023503893
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENESEO FAMILY EYE CARE, LLC
Provider Business Mailing Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-243-2020
Fax Number :
Provider Business Practice Location Address
First Line : 4384 LAKEVILLE RD
Second Line :
City : GENESEO
State : NY
Zip : 14454-9761
Country : US
Telephone Number : 585-243-2020
Fax Number :
Authorized Official
Title or Position : OWNER/OPTOMETRIST
Name : MICHAEL J DOLAN
Credential :
Telephone Number : 585-243-2020
Provider Enumeration Date : 06/25/2018
Last Update Date : 06/25/2018

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Directions to “GENESEO FAMILY EYE CARE, LLC ” Practice Location

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