Individual
MR. THOMAS PATRICK LONGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
1644 MONROE AVE, ROCHESTER, NY 14618-1417
(607) 731-4941
Mailing address
1644 MONROE AVE, ROCHESTER, NY 14618-1417
(607) 731-4941
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
004044-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02913817
—
NY
Enumeration date
07/25/2007
Last updated
09/14/2010
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