MEDICARE: EYES OF ROCK OPTOMETRY P.C.

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	VUT005744	NY

General Provider Information

NPI Number	:	1922325869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYES OF ROCK OPTOMETRY P.C.

Provider Business Mailing Address
First Line	:	24 FAIRVIEW AVE
Second Line	:
City	:	WOODCLIFF LAKE
State	:	NJ
Zip	:	07677-7960
Country	:	US
Telephone Number	:	917-579-2520
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 MAPLE AVE
Second Line	:
City	:	NEW CITY
State	:	NY
Zip	:	10956-5061
Country	:	US
Telephone Number	:	845-639-1200
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. MATTHEW HOROWITZ
Credential	:	O.D.
Telephone Number	:	917-579-2520

Provider Enumeration Date	:	05/03/2010
Last Update Date	:	05/03/2010

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