MEDICARE: YOCHEVED KRESCH

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	4901005359	MI
2	152WC0802X	Corneal and Contact Management Optometrist	4901005359	MI
3	152WP0200X	Pediatric Optometrist	4901005359	MI

General Provider Information

NPI Number	:	1396123469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOCHEVED KRESCH

Provider Business Mailing Address
First Line	:	25211 COOLIDGE HWY
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-3165
Country	:	US
Telephone Number	:	248-545-2800
Fax Number	:	248-581-4074

Provider Business Practice Location Address
First Line	:	25211 COOLIDGE HWY
Second Line	:
City	:	OAK PARK
State	:	MI
Zip	:	48237-3165
Country	:	US
Telephone Number	:	248-545-2800
Fax Number	:	248-581-4074

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

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	03/12/2024

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Directions to “ YOCHEVED KRESCH ” Practice Location

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