MEDICARE: EYE & I EYECARE LLC

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	:	1225704042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE & I EYECARE LLC

Provider Business Mailing Address
First Line	:	19214 NORTHERN BLVD FL 2
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-2955
Country	:	US
Telephone Number	:	718-279-2020
Fax Number	:	202-217-4983

Provider Business Practice Location Address
First Line	:	19214 NORTHERN BLVD FL 2
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-2955
Country	:	US
Telephone Number	:	718-279-2020
Fax Number	:	202-217-4983

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	CRYSTAL HAN
Credential	:	O.D.
Telephone Number	:	516-728-0712

Provider Enumeration Date	:	08/20/2021
Last Update Date	:	08/20/2021

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Directions to “EYE & I EYECARE LLC ” Practice Location

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