MEDICARE: ABOUBACAR SANGARE

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	TU005004	NY

General Provider Information

NPI Number	:	1346786589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOUBACAR SANGARE

Provider Business Mailing Address
First Line	:	1108 RUTLAND RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3646
Country	:	US
Telephone Number	:	718-627-3557
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 RUTLAND RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-3646
Country	:	US
Telephone Number	:	718-627-3557
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABOUBACAR SANGARE
Credential	:
Telephone Number	:	718-627-3557

Provider Enumeration Date	:	01/11/2017
Last Update Date	:	01/11/2017

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Directions to “ABOUBACAR SANGARE ” Practice Location

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