MEDICARE: CONTACT LENS & VISION CONSULTANTS, INC

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	OAO4513	NJ

General Provider Information

NPI Number	:	1669685392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONTACT LENS & VISION CONSULTANTS, INC

Provider Business Mailing Address
First Line	:	5105 KINGS PLZ
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5218
Country	:	US
Telephone Number	:	718-252-8333
Fax Number	:	718-377-7847

Provider Business Practice Location Address
First Line	:	5105 KINGS PLZ
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5218
Country	:	US
Telephone Number	:	718-252-8333
Fax Number	:	718-377-7847

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KERRY MITCHELL GELB
Credential	:	O.D.
Telephone Number	:	718-252-8333

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	04/24/2014

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