MEDICARE: LEXINGTON OPTICAL EXPRESS

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	T005611-1	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	:	1528232030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEXINGTON OPTICAL EXPRESS

Provider Business Mailing Address
First Line	:	2058B LEXINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1732
Country	:	US
Telephone Number	:	212-360-7422
Fax Number	:	212-360-1969

Provider Business Practice Location Address
First Line	:	2058B LEXINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1732
Country	:	US
Telephone Number	:	212-360-7422
Fax Number	:	212-360-1969

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID C HO
Credential	:	OD
Telephone Number	:	212-360-7422

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	04/15/2008

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Directions to “LEXINGTON OPTICAL EXPRESS ” Practice Location

Language	Start Address	Practice Location

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