MEDICARE: AKRON OPTICAL SHOP 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	152W00000X	Optometrist	T004942	NY
2	152W00000X	Optometrist	T002702-1	NY
3	156FX1800X	Optician	006922-1	NY
4	152W00000X	Optometrist	TUV005016-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000390048012	OTHER	NY	COMMUNITY BLUE
2	NY6922	OTHER	NY	EYEMED
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	25460	OTHER	NY	SPECTARA
5	00026880501	OTHER	NY	UNIVERA
6	333701	OTHER	NY	NVA
7	636	OTHER	NY	CSEA
8	000390048012	OTHER	NY	BCBS OF WESTERN NY
9	44765	OTHER	NY	DAVIS

General Provider Information

NPI Number	:	1205861176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKRON OPTICAL SHOP INC.

Provider Business Mailing Address
First Line	:	55 MAIN ST
Second Line	:
City	:	AKRON
State	:	NY
Zip	:	14001-1239
Country	:	US
Telephone Number	:	716-542-2002
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 MAIN ST
Second Line	:
City	:	AKRON
State	:	NY
Zip	:	14001-1239
Country	:	US
Telephone Number	:	716-542-2002
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. GINA LEE SAROW
Credential	:
Telephone Number	:	716-542-2002

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	09/11/2025

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Directions to “AKRON OPTICAL SHOP INC. ” Practice Location

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