MEDICARE: EYEGLASSES STATION INC

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	VUT005834	NY

General Provider Information

NPI Number	:	1164731717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEGLASSES STATION INC

Provider Business Mailing Address
First Line	:	5914 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4169
Country	:	US
Telephone Number	:	347-770-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	5914 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-4169
Country	:	US
Telephone Number	:	347-770-8300
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. WILLIAM LING
Credential	:	OD
Telephone Number	:	347-770-8300

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	06/14/2019

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Directions to “EYEGLASSES STATION INC ” Practice Location

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