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NPI Code Detail

MEDICARE: DR. BRIAN POWELL O.D.

MEDICARE: DR. BRIAN POWELL 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
1152W00000XOptometristVUT005959NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1161526023OTHERNYPOMCO
2P00439185OTHERNYPALMETTO GBA RAILROAD MED
35C8144OTHERNYHEALTHNET INS. OF NY
4P3704610OTHERNYOXFORD HEALTH INSURANCE
5000412569001OTHERNYHEALTHNOW OF N.Y.
6390887OTHERNYM V P
7C480C1OTHERNYEMPIRE BC/BS
810118806OTHERNYC D P H P
91343583OTHERNYAETNA HEALTH INSURANCE

General Provider Information

NPI Number : 1245274620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN POWELL O.D.
Provider Business Mailing Address
First Line : 44 HOOSE BLVD
Second Line :
City : FISHKILL
State : NY
Zip : 12524-3400
Country : US
Telephone Number : 845-896-2427
Fax Number :
Provider Business Practice Location Address
First Line : 969 MAIN ST STE H
Second Line :
City : FISHKILL
State : NY
Zip : 12524-1791
Country : US
Telephone Number : 845-896-6700
Fax Number : 845-896-6882
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 07/27/2012

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