MEDICARE: DR. ROBERT EDMUND BEHAN 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	TUV006641-1	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	:	1275547416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT EDMUND BEHAN O.D.

Provider Business Mailing Address
First Line	:	22 W 13TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-7902
Country	:	US
Telephone Number	:	212-807-0019
Fax Number	:	212-727-2395

Provider Business Practice Location Address
First Line	:	22 W 13TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-7902
Country	:	US
Telephone Number	:	212-807-0019
Fax Number	:	212-727-2395

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	09/09/2008

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