MEDICARE: EYE CARE OPTOMETRY 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	7808	CA
2	152WC0802X	Corneal and Contact Management Optometrist	TUV004353-1	NY
3	152WP0200X	Pediatric Optometrist	TUV004353-1	NY
4	152W00000X	Optometrist	TUV004353-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C42291	OTHER	NY	BLUECROSS BLUESHIELD
2	P12014174	OTHER	NY	MULTIPLAN
3	OXFORD	OTHER	NY	P2625912
4	1518920016	OTHER	NY	PHCS
5	5284334	OTHER	NY	CIGNA
6	863385	OTHER	NY	UNITEDHEALTHCARE

General Provider Information

NPI Number	:	1518920016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CARE OPTOMETRY PC

Provider Business Mailing Address
First Line	:	271-30 77TH AVE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040
Country	:	US
Telephone Number	:	718-343-1414
Fax Number	:	718-343-2578

Provider Business Practice Location Address
First Line	:	27130 77TH AVE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-1446
Country	:	US
Telephone Number	:	718-343-1414
Fax Number	:	718-343-2578

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	DR. DANA GETZ
Credential	:	O.D.
Telephone Number	:	718-343-1414

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	06/11/2009

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