MEDICARE: PATRICIA LABRUNDA O.D

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	TUV005005-1	NY

General Provider Information

NPI Number	:	1093821076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA LABRUNDA O.D

Provider Business Mailing Address
First Line	:	884 BELLIS PKWY
Second Line	:
City	:	ORADELL
State	:	NJ
Zip	:	07649-1944
Country	:	US
Telephone Number	:	201-483-6391
Fax Number	:	914-406-8228

Provider Business Practice Location Address
First Line	:	5 GRACE CHURCH ST
Second Line	:	OPTOMETRY
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4911
Country	:	US
Telephone Number	:	914-937-8899
Fax Number	:	914-406-8228

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	07/08/2007

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