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General NPI Number Information
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NPI Number | 1588102800
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Entity Type | Organization
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Legal Business Name | LONG ISLAND OPTOMETRY CARE, PLLC
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 3 DANIEL WAY
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City | SETAUKET
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State | NY
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Zip | 11733-3054
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Country | US
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Telephone | 800-605-3937
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Fax | 888-747-6545
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Provider Business Mailing Address
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Address Line | 3 DANIEL WAY
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City | SETAUKET
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State | NY
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Zip | 11733-3054
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Country | US
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Telephone | 800-605-3937
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. BRIAN LUDWIG
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Credential | OD
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Telephone | 800-605-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 008113
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License Number State | NY
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