MEDICARE: MDA MANAGEMENT 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	TUV 006977	NY
2	156FX1800X	Optician	007305-1	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	:	1528116282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MDA MANAGEMENT INC

Provider Business Mailing Address
First Line	:	4526 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-2404
Country	:	US
Telephone Number	:	212-304-3585
Fax Number	:

Provider Business Practice Location Address
First Line	:	4526 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10040-2404
Country	:	US
Telephone Number	:	212-304-3585
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LUIDMILA SAPERSON
Credential	:
Telephone Number	:	212-304-3585

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	09/11/2025

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Directions to “MDA MANAGEMENT INC ” Practice Location

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