MEDICARE: EYESITE IN SIGHT 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	:	1982720017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYESITE IN SIGHT INC.

Provider Business Mailing Address
First Line	:	25 OLD SHORE RD
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-2222
Country	:	US
Telephone Number	:	516-944-5509
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 OLD SHORE RD
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-2222
Country	:	US
Telephone Number	:	516-944-5509
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAGMOHAN WALIA
Credential	:	OD
Telephone Number	:	516-944-5509

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/22/2020

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Directions to “EYESITE IN SIGHT INC. ” Practice Location

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