MEDICARE: MR. KONSTANTIN URMAN OPTICIAN

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	156FX1800X	Optician	7603	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	:	1447206610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KONSTANTIN URMAN OPTICIAN

Provider Business Mailing Address
First Line	:	2056 E 56TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4721
Country	:	US
Telephone Number	:	718-353-7352
Fax Number	:	718-353-7563

Provider Business Practice Location Address
First Line	:	2521 PARSONS BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-1247
Country	:	US
Telephone Number	:	718-353-7352
Fax Number	:	718-353-7563

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	12/15/2008

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