Main Street Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

004875 Issued in NY

Legal business name

MAIN STREET OPTICAL

Practice address

1 N Main St
549
Honeoye Falls, NY 14472-1013

Phone

(585) 624-2122

Fax

(585) 624-2122

NPI assigned

May 9, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Barry T Kissack, O.D.

Title

Owner

Phone

(585) 624-2122

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1811164882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N MAIN ST",
            "address_2": "549",
            "city": "HONEOYE FALLS",
            "state": "NY",
            "postal_code": "144721013",
            "telephone_number": "585-624-2122",
            "fax_number": "585-624-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N MAIN ST",
            "address_2": "549",
            "city": "HONEOYE FALLS",
            "state": "NY",
            "postal_code": "144721013",
            "telephone_number": "585-624-2122",
            "fax_number": "585-624-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "KISSACK",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "585-624-2122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NY",
            "license": "004875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31783B",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EXCELLUS BC/BS",
            "identifier": "8788",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "100162",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian S Lang, PT
• Audra A Leboo, MBCHB
• Stephanie Christine Lipary, PHARMD
• Matthew Stephen Lombardozzi, PHARMD.
• Greg B Lowenguth, DDS
• William Michael McGough, LCSW, CASAC
• Laura Anne McNally, LMSW
• Mendon Physical Therapy Management, PC (Honeoye Falls Lima Physical Therapy)
• Meridian Acupuncture PLLC
• Catherine Nolan Minges, TEACHER

• Eyewear Supplier in Honeoye Falls, NY
• Providers in Honeoye Falls, NY by specialty
• Eyewear Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.