Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | C004786-1 | NY |
N | 156FX1800X | Optician | C004786-1 | NY |
NPI | 1871551374 |
---|---|
Provider Name | Mr. Steven Frederick Hickey |
First Address | Fairport, NY 14450-8603 |
Second Address | Rochester, NY 14606-2040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |