MEDICARE: DR. ARTHUR MICHAEL PURVIN 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	TUV003478-1	NY

General Provider Information

NPI Number	:	1083682868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR MICHAEL PURVIN O.D.

Provider Business Mailing Address
First Line	:	10 E. MERRICK RD
Second Line	:	SUIT 01
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-6105
Country	:	US
Telephone Number	:	516-825-7455
Fax Number	:	516-825-1494

Provider Business Practice Location Address
First Line	:	10 E. MERRICK RD.
Second Line	:	SUITE 201
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-6105
Country	:	US
Telephone Number	:	516-825-7455
Fax Number	:	516-825-1494

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	06/07/2010

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