MEDICARE: EYEMAGINATION OPTICAL CORP

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	UV004778	NY

General Provider Information

NPI Number	:	1871631374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEMAGINATION OPTICAL CORP

Provider Business Mailing Address
First Line	:	1633 ROUTE 202 STE 108
Second Line	:
City	:	POMONA
State	:	NY
Zip	:	10970-2926
Country	:	US
Telephone Number	:	845-354-5661
Fax Number	:	845-262-1545

Provider Business Practice Location Address
First Line	:	1633 ROUTE 202 STE 108
Second Line	:
City	:	POMONA
State	:	NY
Zip	:	10970-2926
Country	:	US
Telephone Number	:	845-354-5661
Fax Number	:	845-262-1545

Authorized Official
Title or Position	:	VP
Name	:	DR. DAVID GALINA
Credential	:
Telephone Number	:	845-354-5661

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	03/09/2026

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Directions to “EYEMAGINATION OPTICAL CORP ” Practice Location

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