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NPI Code Detail

MEDICARE: JAMES SIMMONS OPTOMETRIST

MEDICARE: JAMES SIMMONS OPTOMETRIST
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
1152WL0500XLow Vision Rehabilitation OptometristTUV005472-1NY

General Provider Information

NPI Number : 1659343002
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES SIMMONS OPTOMETRIST
Provider Business Mailing Address
First Line : 1170 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14209-2331
Country : US
Telephone Number : 716-882-1025
Fax Number : 716-882-5577
Provider Business Practice Location Address
First Line : 1170 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14209-2331
Country : US
Telephone Number : 716-882-1025
Fax Number : 716-882-5577
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 04/30/2012

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