MEDICARE: SAM G CARIFA OD

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	3928	OH
2	152WV0400X	Vision Therapy Optometrist	960T47	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033129531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAM G CARIFA OD

Provider Business Mailing Address
First Line	:	5797 BEECHCROFT RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-2758
Country	:	US
Telephone Number	:	614-891-0660
Fax Number	:	614-882-4170

Provider Business Practice Location Address
First Line	:	5797 BEECHCROFT RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-2758
Country	:	US
Telephone Number	:	614-891-0660
Fax Number	:	614-882-4170

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	11/15/2012

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Directions to “ SAM G CARIFA OD” Practice Location

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