MEDICARE: DR. MICHAEL CHRISTOPHER MADIGAN O.D.

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	VUT 005829	NY

General Provider Information

NPI Number	:	1376548818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL CHRISTOPHER MADIGAN O.D.

Provider Business Mailing Address
First Line	:	6805 ROUTE 9
Second Line	:	STE 27
City	:	RHINEBECK
State	:	NY
Zip	:	12572-1160
Country	:	US
Telephone Number	:	845-876-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	6805 ROUTE 9
Second Line	:	STE 27
City	:	RHINEBECK
State	:	NY
Zip	:	12572-1160
Country	:	US
Telephone Number	:	845-876-2222
Fax Number	:

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	08/05/2020

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