MEDICARE: BRONX EYE CARE OPTOMETRY PLLC

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

General Provider Information

NPI Number	:	1124194808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONX EYE CARE OPTOMETRY PLLC

Provider Business Mailing Address
First Line	:	2075 BARTOW AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10475-4613
Country	:	US
Telephone Number	:	718-320-0049
Fax Number	:

Provider Business Practice Location Address
First Line	:	1038 SOUTHERN BLVD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10459-3407
Country	:	US
Telephone Number	:	718-328-7137
Fax Number	:	718-378-0160

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	PEARLINA NELMS
Credential	:
Telephone Number	:	718-320-0049

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	10/14/2008

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