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NPI Code Detail

MEDICARE: DR. SHOSHANA CRAIG O.D.

MEDICARE: DR. SHOSHANA CRAIG O.D.
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
1152WV0400XVision Therapy Optometrist006369-1NY

General Provider Information

NPI Number : 1417927963
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHOSHANA CRAIG O.D.
Provider Business Mailing Address
First Line : 29 SCOTT DR
Second Line :
City : MELVILLE
State : NY
Zip : 11747-1013
Country : US
Telephone Number : 516-996-0798
Fax Number :
Provider Business Practice Location Address
First Line : 33 W 42ND ST
Second Line :
City : NEW YORK
State : NY
Zip : 10036-8003
Country : US
Telephone Number : 212-938-5919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 07/08/2007

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