Healthcare Provider Details

I. General information

NPI: 1922148410
Provider Name (Legal Business Name): INSIGHT MANAGED CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 FAIRMONT AVE E
LAKEWOOD NY
14750-2022
US

IV. Provider business mailing address

100 QUENTIN ROOSEVELT BLVD SUITE 508
GARDEN CITY NY
11530-4874
US

V. Phone/Fax

Practice location:
  • Phone: 716-763-1877
  • Fax: 716-763-3179
Mailing address:
  • Phone: 516-390-2101
  • Fax: 516-390-2170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number
License Number StateNY

VIII. Authorized Official

Name: MISS MYLES LEWIS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 516-390-2101