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NPI Code Detail

MEDICARE: MAK OPTICAL OF NEW YORK INC

MEDICARE: MAK OPTICAL OF NEW YORK 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
1156FX1800XOpticianNY7701NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376642975
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAK OPTICAL OF NEW YORK INC
Provider Business Mailing Address
First Line : 6135 JUNCTION BLVD
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2771
Country : US
Telephone Number : 718-459-7100
Fax Number :
Provider Business Practice Location Address
First Line : 6135 JUNCTION BLVD
Second Line :
City : REGO PARK
State : NY
Zip : 11374-2771
Country : US
Telephone Number : 718-459-7100
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : GLEN E SMITH
Credential :
Telephone Number : 718-459-7100
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/10/2015

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Directions to “MAK OPTICAL OF NEW YORK INC ” Practice Location

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