MEDICARE: WHEELS OF VISION, INC.

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	004661	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417938150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHEELS OF VISION, INC.

Provider Business Mailing Address
First Line	:	13809 QUEENS BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-2641
Country	:	US
Telephone Number	:	718-739-6507
Fax Number	:	718-523-7466

Provider Business Practice Location Address
First Line	:	13809 QUEENS BLVD
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-2641
Country	:	US
Telephone Number	:	718-739-6507
Fax Number	:	718-523-7466

Authorized Official
Title or Position	:	OPTICIAN MANAGER
Name	:	MR. ROBERT PHILLIP KAPLAN
Credential	:	OD
Telephone Number	:	718-739-6507

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	12/21/2011

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Directions to “WHEELS OF VISION, INC. ” Practice Location

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