MEDICARE: J S NAUHEIM MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	162799	NY

General Provider Information

NPI Number	:	1023204294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J S NAUHEIM MD PC

Provider Business Mailing Address
First Line	:	2025 MERRICK AVE
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-3146
Country	:	US
Telephone Number	:	516-868-7110
Fax Number	:	516-868-7380

Provider Business Practice Location Address
First Line	:	2025 MERRICK AVE
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-3146
Country	:	US
Telephone Number	:	516-868-7110
Fax Number	:	516-868-7380

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD C NAUHEIM
Credential	:	M.D.
Telephone Number	:	516-868-7110

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	04/25/2019

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