Provider Demographics
NPI:1053578328
Name:HESS OPTOMETRIC ASSOCIATES
Entity type:Organization
Organization Name:HESS OPTOMETRIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:RANDAL
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-775-3051
Mailing Address - Street 1:171 W WASHINGTON ST
Mailing Address - Street 2:P.O. BOX 86
Mailing Address - City:ROCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:15074-2242
Mailing Address - Country:US
Mailing Address - Phone:724-775-3051
Mailing Address - Fax:724-774-5522
Practice Address - Street 1:171 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-2242
Practice Address - Country:US
Practice Address - Phone:724-775-3051
Practice Address - Fax:724-774-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000677152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty