Provider Demographics
NPI:1548350358
Name:VISCO, FRANK EDMUND JR (OD, MS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:EDMUND
Last Name:VISCO
Suffix:JR
Gender:M
Credentials:OD, MS
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Mailing Address - Street 1:3534 STATE ROUTE 215
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-9440
Mailing Address - Country:US
Mailing Address - Phone:832-264-9571
Mailing Address - Fax:
Practice Address - Street 1:1284 DRYDEN RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-8795
Practice Address - Country:US
Practice Address - Phone:607-257-1066
Practice Address - Fax:607-257-1378
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYTUV007249152WC0802X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY007249OtherNY OPTOMETRIST LICENSE
TX6966TOtherTX OPTOMETRIST LICENSE