Provider Demographics
NPI:1548365596
Name:BASKIN, LOUIS E (OD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:E
Last Name:BASKIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 CHILI AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-5440
Mailing Address - Country:US
Mailing Address - Phone:585-889-9696
Mailing Address - Fax:585-889-3558
Practice Address - Street 1:3171 CHILI AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-5440
Practice Address - Country:US
Practice Address - Phone:585-889-9696
Practice Address - Fax:585-889-3558
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT002921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00490088Medicaid
NY0837970001Medicare NSC
NYAA1036Medicare PIN
NYT88403Medicare UPIN