MEDICARE: DR. GARY STEPHAN SAPERSTEIN 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	TUV0003787	NY

General Provider Information

NPI Number	:	1326094053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY STEPHAN SAPERSTEIN O.D.

Provider Business Mailing Address
First Line	:	3539 RIVERDALE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1803
Country	:	US
Telephone Number	:	718-543-4400
Fax Number	:	718-543-4401

Provider Business Practice Location Address
First Line	:	3539 RIVERDALE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-1803
Country	:	US
Telephone Number	:	718-543-4400
Fax Number	:	718-543-4401

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/08/2007

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