MEDICARE: TRISHNA MASTERS O.D.

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	TUV008401-1	NY

General Provider Information

NPI Number	:	1063860039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRISHNA MASTERS O.D.

Provider Business Mailing Address
First Line	:	1650 HIGHWAY 287 N
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-8852
Country	:	US
Telephone Number	:	682-518-1177
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 W 42ND ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10036-8005
Country	:	US
Telephone Number	:	212-938-4001
Fax Number	:

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

Provider Enumeration Date	:	05/31/2016
Last Update Date	:	01/29/2019

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