Provider Demographics
NPI:1861441404
Name:BECKER, STEVEN GEORGE (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GEORGE
Last Name:BECKER
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 1:1709 NORTON ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609
Mailing Address - Country:US
Mailing Address - Phone:585-266-5600
Mailing Address - Fax:585-467-4009
Practice Address - Street 1:1729 NORTON ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609
Practice Address - Country:US
Practice Address - Phone:585-266-5600
Practice Address - Fax:585-467-4009
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004070152W00000X
WI1784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T25912Medicare UPIN