MEDICARE: MRS. SHEILA M THOMAS OPTICIAN

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	156FX1800X	Optician	008995	NY

General Provider Information

NPI Number	:	1326390667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEILA M THOMAS OPTICIAN

Provider Business Mailing Address
First Line	:	1 FOXCARE DR STE 100
Second Line	:
City	:	ONEONTA
State	:	NY
Zip	:	13820-2681
Country	:	US
Telephone Number	:	607-432-1262
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 FOXCARE DR STE 100
Second Line	:
City	:	ONEONTA
State	:	NY
Zip	:	13820-2681
Country	:	US
Telephone Number	:	607-432-1262
Fax Number	:

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

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	10/10/2012

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