Individual
MRS. JENNIFER JEANNE PROIA-CESSNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Mailing address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
(585) 637-4990
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
007235-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598707812
OAK ORCHARD BROCKPORT NPI
NY
01
—
17209159
EXCELLUS VENDOR #
NY
01
—
179014CT
PREFERRED CARE VENDOR #
NY
Enumeration date
07/07/2006
Last updated
09/05/2007
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