MEDICARE: SACHEM OPTICS 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	152W00000X	Optometrist

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	:	1518360924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SACHEM OPTICS INC

Provider Business Mailing Address
First Line	:	655 E MONTAUK HWY STE 29
Second Line	:
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-3154
Country	:	US
Telephone Number	:	631-576-4499
Fax Number	:	631-576-4253

Provider Business Practice Location Address
First Line	:	655 E MONTAUK HWY STE 29
Second Line	:
City	:	EAST PATCHOGUE
State	:	NY
Zip	:	11772-3154
Country	:	US
Telephone Number	:	631-576-4499
Fax Number	:	631-576-4253

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	PATRICIA EDDY
Credential	:
Telephone Number	:	517-231-4086

Provider Enumeration Date	:	09/30/2014
Last Update Date	:	06/28/2021

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Directions to “SACHEM OPTICS INC ” Practice Location

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