MEDICARE: EYES BY LULU

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1386812147
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYES BY LULU

Provider Business Mailing Address
First Line	:	75 W ROUTE 59
Second Line	:	ROOM 1013
City	:	NANUET
State	:	NY
Zip	:	10954-2700
Country	:	US
Telephone Number	:	845-623-4166
Fax Number	:	845-627-1597

Provider Business Practice Location Address
First Line	:	75 W ROUTE 59
Second Line	:	ROOM 1013
City	:	NANUET
State	:	NY
Zip	:	10954-2700
Country	:	US
Telephone Number	:	845-623-4166
Fax Number	:	845-627-1597

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. EVELYN RAMOS
Credential	:
Telephone Number	:	845-623-4166

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	02/14/2008

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Directions to “EYES BY LULU ” Practice Location

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