Provider Demographics
NPI:1396959979
Name:RALPH S. VIOLA, PLLC
Entity type:Organization
Organization Name:RALPH S. VIOLA, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:VIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-586-9900
Mailing Address - Street 1:1157 FAIRPORT RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-1237
Mailing Address - Country:US
Mailing Address - Phone:585-586-9900
Mailing Address - Fax:585-586-7700
Practice Address - Street 1:1157 FAIRPORT RD.
Practice Address - Street 2:SUITE 201
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-1237
Practice Address - Country:US
Practice Address - Phone:585-586-9900
Practice Address - Fax:585-586-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4670120001Medicare NSC