Provider Demographics
NPI:1396780615
Name:LAGANA, MICHELE ANN (OD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:ANN
Last Name:LAGANA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 PARTRIDGE HL
Mailing Address - Street 2:
Mailing Address - City:HONEOYE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14472-9701
Mailing Address - Country:US
Mailing Address - Phone:585-719-7717
Mailing Address - Fax:
Practice Address - Street 1:79 PARTRIDGE HL
Practice Address - Street 2:
Practice Address - City:HONEOYE FALLS
Practice Address - State:NY
Practice Address - Zip Code:14472-9701
Practice Address - Country:US
Practice Address - Phone:585-624-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005364152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010005364OtherBLUE CHOICE
NY102001CSOtherPREFERRED CARE
NY410036954OtherRAILROAD MEDICARE
NMP02005364OtherBLUE CROSS BLUE SHIELD
NY01684160Medicaid
NY5461517OtherAETNA
NYT005364OtherWORKMANS COMPENSATION
NY01684160Medicaid
NY102001CSOtherPREFERRED CARE