MEDICARE: S H LAUFER OF PORT CHESTER INC

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	332H00000X	Eyewear Supplier
2	152W00000X	Optometrist	003036	NY

General Provider Information

NPI Number	:	1184685265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S H LAUFER OF PORT CHESTER INC

Provider Business Mailing Address
First Line	:	511 BOSTON POST RD
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4734
Country	:	US
Telephone Number	:	914-937-3955
Fax Number	:	914-937-0586

Provider Business Practice Location Address
First Line	:	511 BOSTON POST RD
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4734
Country	:	US
Telephone Number	:	914-937-3955
Fax Number	:	914-937-0586

Authorized Official
Title or Position	:	OWNER
Name	:	ELLA KOYFMAN
Credential	:
Telephone Number	:	914-937-3955

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	04/22/2015

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