MEDICARE: COURAGEOUS OPTICAL LLC

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

General Provider Information

NPI Number	:	1578318028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COURAGEOUS OPTICAL LLC

Provider Business Mailing Address
First Line	:	144 HIGH POINT CIR
Second Line	:
City	:	NEWBURGH
State	:	NY
Zip	:	12550-7243
Country	:	US
Telephone Number	:	845-728-2802
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 LEE BLVD STE K02
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-1160
Country	:	US
Telephone Number	:	914-245-8111
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. ANDREW FREILICH
Credential	:	OD
Telephone Number	:	845-728-2802

Provider Enumeration Date	:	04/18/2024
Last Update Date	:	04/18/2024

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Directions to “COURAGEOUS OPTICAL LLC ” Practice Location

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