MEDICARE: USA OPTICAL 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	156F00000X	Technician/Technologist

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	:	1326182858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	USA OPTICAL LLC

Provider Business Mailing Address
First Line	:	330 W 38TH ST
Second Line	:	#805
City	:	NEW YORK
State	:	NY
Zip	:	10018-2999
Country	:	US
Telephone Number	:	212-594-0751
Fax Number	:	212-594-0753

Provider Business Practice Location Address
First Line	:	2856 3RD AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-2717
Country	:	US
Telephone Number	:	718-585-5100
Fax Number	:	718-292-0805

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PETER J BROWN
Credential	:
Telephone Number	:	212-594-0751

Provider Enumeration Date	:	02/17/2007
Last Update Date	:	08/22/2020

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Directions to “USA OPTICAL LLC ” Practice Location

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