MEDICARE: THE EYE CENTER OF GARDEN CITY PA

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

General Provider Information

NPI Number	:	1083171425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE EYE CENTER OF GARDEN CITY PA

Provider Business Mailing Address
First Line	:	3101 E KANSAS AVE STE 9
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6994
Country	:	US
Telephone Number	:	620-272-9667
Fax Number	:	620-260-9548

Provider Business Practice Location Address
First Line	:	3101 E KANSAS AVE STE 9
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-6994
Country	:	US
Telephone Number	:	620-272-9667
Fax Number	:	620-260-9548

Authorized Official
Title or Position	:	CEO
Name	:	DR. JARED TORRES
Credential	:	OD
Telephone Number	:	620-521-9791

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	02/21/2019

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Directions to “THE EYE CENTER OF GARDEN CITY PA ” Practice Location

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