MEDICARE: DR. CASIMIR KAROL BOBOWSKI 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	TUV0042591	NY

General Provider Information

NPI Number	:	1326034240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CASIMIR KAROL BOBOWSKI OD

Provider Business Mailing Address
First Line	:	1342 NEW SENECA TPKE
Second Line	:
City	:	SKANEATELES
State	:	NY
Zip	:	13152-8802
Country	:	US
Telephone Number	:	315-685-6185
Fax Number	:	315-685-2235

Provider Business Practice Location Address
First Line	:	1342 NEW SENECA TPKE
Second Line	:
City	:	SKANEATELES
State	:	NY
Zip	:	13152-8802
Country	:	US
Telephone Number	:	315-685-6185
Fax Number	:	315-685-2235

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	05/29/2008

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