MEDICARE: EYES AND OPTICS

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

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	:	1467640243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYES AND OPTICS

Provider Business Mailing Address
First Line	:	4901 9TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2423
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 9TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-2423
Country	:	US
Telephone Number	:	718-283-8639
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AVRAHAM VIZEL
Credential	:
Telephone Number	:	718-283-7999

Provider Enumeration Date	:	10/05/2007
Last Update Date	:	12/07/2007

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Directions to “EYES AND OPTICS ” Practice Location

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