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NPI Code Detail

MEDICARE: UNIVERSITY OPTICAL CORP

MEDICARE: UNIVERSITY OPTICAL CORP
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
1156FX1800XOptician
2332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100011258003OTHERNYUNIVERA HEALTHCARE BUFFAL
2OP1387OTHERNYEYEMED/INDEPENDENT HEALTH
3106386CTOTHERNYPREFERRED CARE
4P017157362OTHERNYBCBS ROCHESTER
50005177624OTHERNYAETNA

General Provider Information

NPI Number : 1962479949
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OPTICAL CORP
Provider Business Mailing Address
First Line : 2469 STATE ROUTE 19 N
Second Line :
City : WARSAW
State : NY
Zip : 14569-9336
Country : US
Telephone Number : 585-786-8505
Fax Number : 585-786-8490
Provider Business Practice Location Address
First Line : 2469 STATE ROUTE 19 N
Second Line :
City : WARSAW
State : NY
Zip : 14569-9336
Country : US
Telephone Number : 585-786-8505
Fax Number : 585-786-8490
Authorized Official
Title or Position : BUSINESS MANAGER
Name : MS. JENNIFER C. HUBER
Credential :
Telephone Number : 585-786-8505
Provider Enumeration Date : 03/08/2006
Last Update Date : 01/11/2008

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Directions to “UNIVERSITY OPTICAL CORP ” Practice Location

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