Organization
FOUR CORNERS OPTOMETRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY T KISSACK O.D. (PRESIDENT)
(585) 624-2585
Entity
Organization
Contact information
Practice address
7 N MAIN ST, #549, HONEOYE FALLS, NY 14472-1013
(585) 624-2585
(585) 624-3140
Mailing address
7 N MAIN ST, #549, HONEOYE FALLS, NY 14472-1013
(585) 624-2585
(585) 624-3140
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT-004875
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01110127
—
NY
Enumeration date
05/20/2011
Last updated
05/20/2011
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