Provider Demographics
NPI:1811958507
Name:TAO, FELIX JOSEPH (OD)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:JOSEPH
Last Name:TAO
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 1:2375 ROCHESTER RD STE 500
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-7509
Mailing Address - Country:US
Mailing Address - Phone:585-393-0031
Mailing Address - Fax:585-393-0032
Practice Address - Street 1:2375 ROCHESTER RD STE 500
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-7509
Practice Address - Country:US
Practice Address - Phone:585-393-0031
Practice Address - Fax:585-393-0032
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT0063481152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRB0314Medicare PIN
NYRB0315Medicare PIN
U86177Medicare UPIN
NYRB0316Medicare PIN
NYRB0315Medicare PIN