MEDICARE: VISION ASSOCIATES OF ROCHESTER

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
1	332H00000X	Eyewear Supplier	2774191	MN

General Provider Information

NPI Number	:	1093069197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISION ASSOCIATES OF ROCHESTER

Provider Business Mailing Address
First Line	:	1260 LYELL AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14606-2040
Country	:	US
Telephone Number	:	585-254-0022
Fax Number	:	585-254-5026

Provider Business Practice Location Address
First Line	:	2449 3RD AVE S
Second Line	:	C26
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55404-2690
Country	:	US
Telephone Number	:	585-254-0022
Fax Number	:	585-254-5026

Authorized Official
Title or Position	:	OWER/OFFICER
Name	:	MR. TIMOTHY HO
Credential	:
Telephone Number	:	585-254-0022

Provider Enumeration Date	:	10/29/2012
Last Update Date	:	10/29/2012

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