MEDICARE: VEYANA OPTICAL

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	007361-01	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	:	1740385194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEYANA OPTICAL

Provider Business Mailing Address
First Line	:	6 NEWKIRK PLAZA
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6526
Country	:	US
Telephone Number	:	718-421-7209
Fax Number	:	718-421-7209

Provider Business Practice Location Address
First Line	:	6 NEWKIRK PLAZA
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-6526
Country	:	US
Telephone Number	:	718-421-7209
Fax Number	:	718-421-7209

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. YAN KOTLYAR
Credential	:
Telephone Number	:	718-421-7209

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	08/22/2020

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Directions to “VEYANA OPTICAL ” Practice Location

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