MEDICARE: DR BURT S ESCHEN 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	TUV003441-1	NY

General Provider Information

NPI Number	:	1851560551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR BURT S ESCHEN PC

Provider Business Mailing Address
First Line	:	2821 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5053
Country	:	US
Telephone Number	:	718-648-0964
Fax Number	:	718-616-0575

Provider Business Practice Location Address
First Line	:	2821 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5053
Country	:	US
Telephone Number	:	718-648-0964
Fax Number	:	718-616-0575

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BURT S ESCHEN
Credential	:	O.D.
Telephone Number	:	718-648-0964

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	04/14/2010

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