MEDICARE: ZIEKER EYE OPHTHALMOLOGY, P.C.

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	261QS0132X	Ophthalmologic Surgery Clinic/Center	237533	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	:	1346543147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZIEKER EYE OPHTHALMOLOGY, P.C.

Provider Business Mailing Address
First Line	:	14 MOUNTAIN LEDGE DR.
Second Line	:
City	:	WILTON
State	:	NY
Zip	:	12831-1858
Country	:	US
Telephone Number	:	518-450-1080
Fax Number	:	518-478-8500

Provider Business Practice Location Address
First Line	:	14 MOUNTAIN LEDGE
Second Line	:
City	:	WILTON
State	:	NY
Zip	:	12831-1858
Country	:	US
Telephone Number	:	518-450-1080
Fax Number	:	518-478-8500

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. CHRISTOPHER R ZIEKER
Credential	:	M.D.
Telephone Number	:	518-450-1080

Provider Enumeration Date	:	12/16/2010
Last Update Date	:	03/22/2012

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