MEDICARE: JOSEPH PACHT 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	3672	NY

General Provider Information

NPI Number	:	1538293048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH PACHT OPTICIAN

Provider Business Mailing Address
First Line	:	3265 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3649
Country	:	US
Telephone Number	:	516-763-2020
Fax Number	:	516-763-9880

Provider Business Practice Location Address
First Line	:	3265 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-3649
Country	:	US
Telephone Number	:	516-763-2020
Fax Number	:	516-763-9880

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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Directions to “ JOSEPH PACHT OPTICIAN” Practice Location

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