MEDICARE: DR. RORY ADAM BOWMAN

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	TUV006653	NY

General Provider Information

NPI Number	:	1093788945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RORY ADAM BOWMAN

Provider Business Mailing Address
First Line	:	3450 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-5440
Country	:	US
Telephone Number	:	516-668-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 LONG BEACH RD
Second Line	:
City	:	OCEANSIDE
State	:	NY
Zip	:	11572-5440
Country	:	US
Telephone Number	:	516-678-1616
Fax Number	:

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

Provider Enumeration Date	:	02/10/2006
Last Update Date	:	08/21/2009

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