MEDICARE: SVC OF MURRAY HILL, LLC

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	332H00000X	Eyewear Supplier
2	152W00000X	Optometrist

General Provider Information

NPI Number	:	1134736945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SVC OF MURRAY HILL, LLC

Provider Business Mailing Address
First Line	:	1224 OSTRANDER AVENUE
Second Line	:
City	:	RIVERHEAD
State	:	NY
Zip	:	11901
Country	:	US
Telephone Number	:	631-727-2858
Fax Number	:	631-727-2866

Provider Business Practice Location Address
First Line	:	458 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-6027
Country	:	US
Telephone Number	:	212-969-5990
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL / OWNER
Name	:	DR. JEFFREY S WILLIAMS JR.
Credential	:	OD
Telephone Number	:	631-422-2442

Provider Enumeration Date	:	09/25/2020
Last Update Date	:	12/03/2020

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