MEDICARE: PORT CHESTER EYECARE 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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1912166885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PORT CHESTER EYECARE INC

Provider Business Mailing Address
First Line	:	44 N MAIN ST
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4252
Country	:	US
Telephone Number	:	914-481-1577
Fax Number	:	914-481-1576

Provider Business Practice Location Address
First Line	:	44 N MAIN ST
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4252
Country	:	US
Telephone Number	:	914-481-1577
Fax Number	:	914-481-1576

Authorized Official
Title or Position	:	OWNER
Name	:	MISS JANETE SUCENA
Credential	:
Telephone Number	:	914-481-1577

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	08/02/2024

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Directions to “PORT CHESTER EYECARE INC ” Practice Location

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