MEDICARE: DR. KAREN GAIL FLIEGELMAN O.D.

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	TUV005948-1	NY
2	152W00000X	Optometrist	27OA00564800	NJ

General Provider Information

NPI Number	:	1548552185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN GAIL FLIEGELMAN O.D.

Provider Business Mailing Address
First Line	:	207 VAN HOUTEN AVE
Second Line	:
City	:	PASSAIC
State	:	NJ
Zip	:	07055-4606
Country	:	US
Telephone Number	:	973-815-9989
Fax Number	:

Provider Business Practice Location Address
First Line	:	1823 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5308
Country	:	US
Telephone Number	:	718-377-5649
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2011
Last Update Date	:	05/13/2011

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