Individual
TINA REEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
17 STATE ST, POWERS BUILDING ATRIUM, ROCHESTER, NY 14614-1302
(585) 797-0601
(585) 340-7950
Mailing address
17 STATE ST, POWERS BUILDING ATRIUM, ROCHESTER, NY 14614-1302
(585) 797-0601
(585) 797-0603
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
UVT005332
NY
332H00000X
Eyewear Supplier
UVT005332
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101998CS
PREFERRED CARE
NY
01
—
5773707
AETNA
NY
01
—
P010005332
BCBS OF ROCHESTER AREA
NY
Enumeration date
01/17/2006
Last updated
04/17/2020
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