Active NPI
Bruce Alan Pfeffer, PH.D.
- Ophthalmic Technician/Technologist
- Fairport, NY
National Provider Identifier
1730400169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Technician/Technologist
- License
- 111111
- Practice address
- 9 Old Post Rd
Fairport, NY 14450-2920 - Phone
- (585) 388-8408
- NPI assigned
- Jun 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Technician/Technologist | 156FX1100X | 111111 | NY | Primary |
Addresses
Primary practice location
9 Old Post Rd
Fairport, NY 14450-2920
Mailing address
9 Old Post Rd
Fairport, NY 14450-2920
Phone (585) 388-8408
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1111111111 | Other | NY | VA-WNY HEALTHCARE SYSTEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111111 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277078400000",
"number": "1730400169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 OLD POST RD",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144502920",
"telephone_number": "585-388-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 OLD POST RD",
"city": "FAIRPORT",
"state": "NY",
"postal_code": "144502920",
"telephone_number": "585-388-8408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PFEFFER",
"first_name": "BRUCE",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-21",
"last_updated": "2010-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1100X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic",
"state": "NY",
"license": "111111",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA-WNY HEALTHCARE SYSTEM",
"identifier": "1111111111",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.