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NPI Code Detail

MEDICARE: LONG ISLAND VISION OPTOMETRY P.C.

MEDICARE: LONG ISLAND VISION 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
1152W00000XOptometrist

General Provider Information

NPI Number : 1942865969
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONG ISLAND VISION OPTOMETRY P.C.
Provider Business Mailing Address
First Line : 1701 SUNRISE HWY UNIT N22
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-9217
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 SUNRISE HWY UNIT N22
Second Line :
City : BAY SHORE
State : NY
Zip : 11706-9217
Country : US
Telephone Number : 631-980-2020
Fax Number :
Authorized Official
Title or Position : OWNER/OPTOMETRIST
Name : ELENA FELDMAN
Credential : OD
Telephone Number : 646-734-6367
Provider Enumeration Date : 05/06/2019
Last Update Date : 05/06/2019

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