Provider Demographics
NPI:1407616394
Name:JOSEPH VAN CURA OD PC
Entity Type:Organization
Organization Name:JOSEPH VAN CURA OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:VAN CURA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:585-872-4006
Mailing Address - Street 1:900 HOLT RD STE 10
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9102
Mailing Address - Country:US
Mailing Address - Phone:585-872-4006
Mailing Address - Fax:585-872-4021
Practice Address - Street 1:900 HOLT RD STE 10
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-9102
Practice Address - Country:US
Practice Address - Phone:585-872-4006
Practice Address - Fax:585-872-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05670017Medicaid