MEDICARE: OCEAN EYE CARE MEDICAL PC

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	261QM2500X	Medical Specialty Clinic/Center	202022	NY
2	207W00000X	Ophthalmology Physician

General Provider Information

NPI Number	:	1316072507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN EYE CARE MEDICAL PC

Provider Business Mailing Address
First Line	:	40 W BRIGHTON AVE STE 103
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-4901
Country	:	US
Telephone Number	:	718-996-2260
Fax Number	:	718-996-1123

Provider Business Practice Location Address
First Line	:	40 W BRIGHTON AVE STE 103
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-4901
Country	:	US
Telephone Number	:	718-996-2260
Fax Number	:	718-996-1123

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANNA LEV BENTSIANOV
Credential	:	M.D.
Telephone Number	:	718-996-2260

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	05/05/2023

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40 W BRIGHTON AVE STE 103 , SUITE 1E
BROOKLYN, NY
11224-4901

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Practice Location Address:

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Practice Location Address:

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Practice Fax:

1861639296 — IRINA BERLIN MEDICAL PC
Practice Location Address:

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Directions to “OCEAN EYE CARE MEDICAL PC ” Practice Location

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