MEDICARE: EYES ON KIDS LLC

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	007837	NY

General Provider Information

NPI Number	:	1598200628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYES ON KIDS LLC

Provider Business Mailing Address
First Line	:	341 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-1443
Country	:	US
Telephone Number	:	718-946-5060
Fax Number	:	718-732-2867

Provider Business Practice Location Address
First Line	:	341 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-1443
Country	:	US
Telephone Number	:	718-946-5060
Fax Number	:	718-732-2867

Authorized Official
Title or Position	:	OWNER
Name	:	HAIM VICTOR COHEN
Credential	:	O.D.
Telephone Number	:	347-392-2673

Provider Enumeration Date	:	12/28/2016
Last Update Date	:	12/28/2016

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Directions to “EYES ON KIDS LLC ” Practice Location

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