Provider Demographics
NPI:1720117294
Name:FINE EYECARE ASSOCIATES
Entity Type:Organization
Organization Name:FINE EYECARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:B.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:585-424-5050
Mailing Address - Street 1:381 WHITE SPRUCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1603
Mailing Address - Country:US
Mailing Address - Phone:585-424-5050
Mailing Address - Fax:585-424-1009
Practice Address - Street 1:381 WHITE SPRUCE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-1603
Practice Address - Country:US
Practice Address - Phone:585-424-5050
Practice Address - Fax:585-424-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT003075332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00451794Medicaid
NY00451794Medicaid
NYW52307Medicare UPIN
NY0128020001Medicare NSC