MEDICARE: SAFI OPTOMETRIST PC

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	TUV5797	NY

General Provider Information

NPI Number	:	1689068827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAFI OPTOMETRIST PC

Provider Business Mailing Address
First Line	:	7903 BREWERTON RD
Second Line	:
City	:	CICERO
State	:	NY
Zip	:	13039-9531
Country	:	US
Telephone Number	:	315-699-1700
Fax Number	:	315-699-1707

Provider Business Practice Location Address
First Line	:	7903 BREWERTON RD
Second Line	:
City	:	CICERO
State	:	NY
Zip	:	13039-9531
Country	:	US
Telephone Number	:	315-699-1700
Fax Number	:	315-699-1707

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANTHONY MONDO
Credential	:	O.D.
Telephone Number	:	315-729-7627

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	07/20/2017

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