MEDICARE: DR. PAUL M BREUER 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	TUV0029971	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	:	1083675037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL M BREUER OD

Provider Business Mailing Address
First Line	:	495 FT WASHINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-4626
Country	:	US
Telephone Number	:	212-928-1171
Fax Number	:	212-543-0666

Provider Business Practice Location Address
First Line	:	495 FT WASHINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-4626
Country	:	US
Telephone Number	:	212-928-1171
Fax Number	:	212-543-0666

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/08/2007

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