Provider Demographics
NPI:1225251994
Name:LOUIS E. BASKIN, O.D.
Entity Type:Organization
Organization Name:LOUIS E. BASKIN, O.D.
Other - Org Name:CHILI VISION GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:585-889-9693
Mailing Address - Street 1:3171 CHILI AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-5440
Mailing Address - Country:US
Mailing Address - Phone:585-889-9693
Mailing Address - Fax:585-889-3558
Practice Address - Street 1:3171 CHILI AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5440
Practice Address - Country:US
Practice Address - Phone:585-889-9693
Practice Address - Fax:585-889-3558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT002921152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00490088Medicaid
NY0837970001Medicare NSC
NYAA1036Medicare PIN