Organization
C&L PERFECT IMAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHERINE M. GRADY CMF (CERTIFIED MASTECTOMY FITTER)
(585) 223-0610
Entity
Organization
Contact information
Practice address
240 PACKETTS LNDG, FAIRPORT, NY 14450-1569
(585) 223-0610
(585) 223-0613
Mailing address
240 PACKETTS LNDG, FAIRPORT, NY 14450-1569
(585) 223-0610
(585) 223-0613
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
C16385
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105976XX
PREFERRED CARE
NY
01
—
CLP240144
EXCELLUS BC/BS
NY
01
—
PIMAGEPERFE
EXCELLUS
NY
Enumeration date
03/22/2006
Last updated
08/22/2020
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