MEDICARE: SORDAT VISION ASSOCIATES INC

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	156FX1800X	Optician	005225	NY

General Provider Information

NPI Number	:	1184957169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SORDAT VISION ASSOCIATES INC

Provider Business Mailing Address
First Line	:	3130 MONROE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-4606
Country	:	US
Telephone Number	:	585-383-8320
Fax Number	:

Provider Business Practice Location Address
First Line	:	3130 MONROE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-4606
Country	:	US
Telephone Number	:	585-383-8320
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ANGLO TADROS
Credential	:
Telephone Number	:	585-383-8320

Provider Enumeration Date	:	09/09/2009
Last Update Date	:	09/09/2009

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