MEDICARE: PAMELA A WEBER

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	207W00000X	Ophthalmology Physician	1657721	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	:	1235111089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA A WEBER

Provider Business Mailing Address
First Line	:	1500 WILLIAM FLOYD PKWY
Second Line	:	SUITE 304
City	:	SHIRLEY
State	:	NY
Zip	:	11967
Country	:	US
Telephone Number	:	631-924-4300
Fax Number	:	631-924-2525

Provider Business Practice Location Address
First Line	:	1500 WILLIAM FLOYD PKWY
Second Line	:	SUITE 304
City	:	SHIRLEY
State	:	NY
Zip	:	11967
Country	:	US
Telephone Number	:	631-924-4300
Fax Number	:	631-924-2525

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	05/16/2017

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Directions to “ PAMELA A WEBER ” Practice Location

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