Provider Demographics
NPI:1629114921
Name:AURORA OPTOMETRIC GROUP, P.C.
Entity Type:Organization
Organization Name:AURORA OPTOMETRIC GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGODZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-652-0870
Mailing Address - Street 1:980 W MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059-9397
Mailing Address - Country:US
Mailing Address - Phone:716-652-0870
Mailing Address - Fax:716-652-2071
Practice Address - Street 1:980 WEST MAPLE COURT
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:NY
Practice Address - Zip Code:14059-9530
Practice Address - Country:US
Practice Address - Phone:716-652-0870
Practice Address - Fax:716-652-2071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT4730152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty