MEDICARE: MANHATTAN EYEWORKS 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
1	302F00000X	Exclusive Provider Organization	NY4780	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	:	1720269756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANHATTAN EYEWORKS INC.

Provider Business Mailing Address
First Line	:	169 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-2927
Country	:	US
Telephone Number	:	212-460-9240
Fax Number	:

Provider Business Practice Location Address
First Line	:	169 1ST AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10003-2927
Country	:	US
Telephone Number	:	212-460-9240
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/CO-OWNER
Name	:	MR. FRANK C FICO
Credential	:
Telephone Number	:	212-460-9240

Provider Enumeration Date	:	11/19/2007
Last Update Date	:	09/16/2013

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