MEDICARE: GY OPTOMETRY CARE, 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	152W00000X	Optometrist	TUV006805	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1427121235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GY OPTOMETRY CARE, PC

Provider Business Mailing Address
First Line	:	3511 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4516
Country	:	US
Telephone Number	:	718-377-1021
Fax Number	:	718-513-1258

Provider Business Practice Location Address
First Line	:	3511 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4516
Country	:	US
Telephone Number	:	718-377-1021
Fax Number	:	718-513-1258

Authorized Official
Title or Position	:	OWNER
Name	:	DR. YULIYA ROYTMAN
Credential	:	OD
Telephone Number	:	718-377-1021

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	08/13/2013

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