MEDICARE: OPTICA HALPERIN

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	:	1396981502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTICA HALPERIN

Provider Business Mailing Address
First Line	:	4607 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4607 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-2631
Country	:	US
Telephone Number	:	718-484-7282
Fax Number	:	718-484-7283

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	YEHUDA HALPERIN
Credential	:
Telephone Number	:	718-909-6865

Provider Enumeration Date	:	12/18/2008
Last Update Date	:	12/18/2008

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