MEDICARE: DR. WIDAD ARTAGRACE VALME OD

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	152W00000X	Optometrist	TUV0068901	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053330050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WIDAD ARTAGRACE VALME OD

Provider Business Mailing Address
First Line	:	1615 CORTELYOU RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5209
Country	:	US
Telephone Number	:	718-826-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 CORTELYOU RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5209
Country	:	US
Telephone Number	:	718-826-2020
Fax Number	:	718-826-2022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	03/31/2009

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