Individual
SHELBY ROCKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6500 PORTER RD STE 2020, NIAGARA FALLS, NY 14304-1529
(716) 282-1114
(716) 282-0523
Mailing address
6500 PORTER RD STE 2020, NIAGARA FALLS, NY 14304-1529
(716) 282-1114
(716) 282-0523
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008833-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
NY
Enumeration date
07/11/2018
Last updated
07/11/2018
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