MEDICARE: DR. BONNIE SAGER 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	003688	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194704908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BONNIE SAGER O.D.

Provider Business Mailing Address
First Line	:	60 SALEM RIDGE DR
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-3015
Country	:	US
Telephone Number	:	631-423-3215
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 E MAIN ST
Second Line	:
City	:	OYSTER BAY
State	:	NY
Zip	:	11771-2405
Country	:	US
Telephone Number	:	516-922-2533
Fax Number	:

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	09/03/2009

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