MEDICARE: JEFFREY ABRAMOWITZ OPHTHALMIC DISPENSER

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	156FX1800X	Optician	31TD00352800	NJ

General Provider Information

NPI Number	:	1649502956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY ABRAMOWITZ OPHTHALMIC DISPENSER

Provider Business Mailing Address
First Line	:	1577 E 12TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7101
Country	:	US
Telephone Number	:	347-713-3667
Fax Number	:	347-713-3667

Provider Business Practice Location Address
First Line	:	222 RIVER AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4807
Country	:	US
Telephone Number	:	732-363-4466
Fax Number	:	732-363-4466

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

Provider Enumeration Date	:	02/11/2010
Last Update Date	:	02/11/2010

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