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General NPI Number Information
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NPI Number | 1699576140
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Entity Type | Organization
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Legal Business Name | OCEAN EYE CARE OPTOMETRY PLLC
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Dates
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Enumeration Date | 03/21/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 16 OLD RIVERHEAD RD
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City | WESTHAMPTON BEACH
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State | NY
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Zip | 11978-1401
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Country | US
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Telephone | 631-903-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 16 OLD RIVERHEAD RD
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City | WESTHAMPTON BEACH
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State | NY
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Zip | 11978-1401
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Country | US
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Telephone | 631-898-5000
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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. PETER WAGONER
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Credential | OD
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Telephone | 631-903-3348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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