Provider Demographics
NPI:1356322044
Name:BUTTAGGI, LEE J (OD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:J
Last Name:BUTTAGGI
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:2300 BUFFALO RD
Mailing Address - Street 2:BLDG 700
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-1360
Mailing Address - Country:US
Mailing Address - Phone:585-328-0153
Mailing Address - Fax:585-328-0158
Practice Address - Street 1:2300 BUFFALO RD
Practice Address - Street 2:BLDG 700
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-1360
Practice Address - Country:US
Practice Address - Phone:585-328-0153
Practice Address - Fax:585-328-0158
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYTUV0046491152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11217DMedicare PIN
U49432Medicare UPIN