MEDICARE: DR. SHANA FARBER KORMAN OPTOMETRIST

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	OEG001133	PA
2	152W00000X	Optometrist	584	NV

General Provider Information

NPI Number	:	1649312323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHANA FARBER KORMAN OPTOMETRIST

Provider Business Mailing Address
First Line	:	2870 BICENTENNIAL PKWY
Second Line	:	SUITE 130
City	:	HENDERSON
State	:	NV
Zip	:	89044-4480
Country	:	US
Telephone Number	:	702-459-3937
Fax Number	:	702-459-3902

Provider Business Practice Location Address
First Line	:	2870 BICENTENNIAL PKWY
Second Line	:	SUITE 130
City	:	HENDERSON
State	:	NV
Zip	:	89044-4480
Country	:	US
Telephone Number	:	702-459-3937
Fax Number	:	702-459-3902

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

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	12/19/2008

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