MEDICARE: PASKOWSKI-WEITZ P C

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	004927	NY
2	152W00000X	Optometrist	003596	NY

General Provider Information

NPI Number	:	1548439292
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASKOWSKI-WEITZ P C

Provider Business Mailing Address
First Line	:	4820 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4820 5TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220
Country	:	US
Telephone Number	:	718-439-7070
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	BERNARD H WEITZ
Credential	:	OD
Telephone Number	:	718-439-7070

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	02/13/2012

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