Provider Demographics
NPI:1467790972
Name:HUSSAIN, LORRAINE ANN
Entity Type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:ANN
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LORRAINE
Other - Middle Name:ANN
Other - Last Name:HUSSAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OPTICIAN
Mailing Address - Street 1:919 WESTFALL RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2638
Mailing Address - Country:US
Mailing Address - Phone:585-463-2600
Mailing Address - Fax:585-473-3695
Practice Address - Street 1:919 WESTFALL RD BLDG B
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2638
Practice Address - Country:US
Practice Address - Phone:585-463-2600
Practice Address - Fax:585-473-3695
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC007270-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician