Provider Demographics
NPI:1598948630
Name:ALLENS CREEK FAMILY OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:ALLENS CREEK FAMILY OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPLOW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:585-461-6225
Mailing Address - Street 1:20 ALLENS CREEK RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3228
Mailing Address - Country:US
Mailing Address - Phone:585-461-6225
Mailing Address - Fax:
Practice Address - Street 1:20 ALLENS CREEK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3228
Practice Address - Country:US
Practice Address - Phone:585-461-6225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT004673152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty