MEDICARE: WASHINGTON HEIGHTS OPTICAL 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	156FX1202X	Optometric Technician

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
2	333512	OTHER	NY	NVA
3	CT2804	OTHER	NY	EYE MED
4	40574	OTHER	NY	DAVIS VISION
5	12852	OTHER	NY	SPECTERA
6	59C0181	OTHER	NY	COMMUNITY PREMIER PLUS

General Provider Information

NPI Number	:	1477635142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON HEIGHTS OPTICAL INC.

Provider Business Mailing Address
First Line	:	8 BIRDIE RD
Second Line	:
City	:	MONTEBELLO
State	:	NY
Zip	:	10901-3940
Country	:	US
Telephone Number	:	845-357-3284
Fax Number	:	212-569-9100

Provider Business Practice Location Address
First Line	:	4211 BROADWAY
Second Line	:	GEORGE WASHINGTON BRIDGE BUS STATION
City	:	NEW YORK
State	:	NY
Zip	:	10033-3747
Country	:	US
Telephone Number	:	212-928-9590
Fax Number	:	212-569-9100

Authorized Official
Title or Position	:	OWNER
Name	:	NORICE ORMSBY
Credential	:
Telephone Number	:	212-928-9590

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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Directions to “WASHINGTON HEIGHTS OPTICAL INC. ” Practice Location

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