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NPI Code Detail

MEDICARE: SOUTHERN DUTCHESS EYECARE, LLP

MEDICARE: SOUTHERN DUTCHESS EYECARE, LLP
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
1152W00000XOptometrist004490NY

General Provider Information

NPI Number : 1063420388
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN DUTCHESS EYECARE, LLP
Provider Business Mailing Address
First Line : 969 MAIN ST STE H
Second Line :
City : FISHKILL
State : NY
Zip : 12524-1791
Country : US
Telephone Number : 845-896-6700
Fax Number : 845-896-6882
Provider Business Practice Location Address
First Line : 969 MAIN ST STE H
Second Line :
City : FISHKILL
State : NY
Zip : 12524-1791
Country : US
Telephone Number : 845-896-6700
Fax Number : 845-896-6882
Authorized Official
Title or Position : PARTNER
Name : DR. BRIAN D PERALTA
Credential : OD
Telephone Number : 845-896-6700
Provider Enumeration Date : 08/03/2006
Last Update Date : 07/26/2012

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Directions to “SOUTHERN DUTCHESS EYECARE, LLP ” Practice Location

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