Provider Demographics
NPI:1497771646
Name:NEURO-OPHTHALMOLOGY CONSULTANTS OF ROCHESTER
Entity Type:Organization
Organization Name:NEURO-OPHTHALMOLOGY CONSULTANTS OF ROCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-461-5330
Mailing Address - Street 1:200 CANAL VIEW BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2852
Mailing Address - Country:US
Mailing Address - Phone:585-461-5330
Mailing Address - Fax:585-461-9895
Practice Address - Street 1:200 CANAL VIEW BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2852
Practice Address - Country:US
Practice Address - Phone:585-461-5330
Practice Address - Fax:585-461-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0459Medicare ID - Type Unspecified