Provider Demographics
NPI:1841245008
Name:CRABLE, JAMES B (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:CRABLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:315-483-8300
Mailing Address - Fax:
Practice Address - Street 1:6353 RIDGE RD
Practice Address - Street 2:
Practice Address - City:SODUS
Practice Address - State:NY
Practice Address - Zip Code:14551
Practice Address - Country:US
Practice Address - Phone:315-483-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004274152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY101959CSOtherPREFERRED CARE
NY11334411OtherCAQH
NY410049107OtherMEDICARE RAILROAD
NY00355266Medicaid
NY00027231701OtherUNIVERA
NYP010004274OtherBLUE CHOICE
NY17807RMedicare ID - Type Unspecified
NY00355266Medicaid