MEDICARE: FRUM OPTICIAN

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	332H00000X	Eyewear Supplier	6007	NY

General Provider Information

NPI Number	:	1699815258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRUM OPTICIAN

Provider Business Mailing Address
First Line	:	1205 JERICHO TPKE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-4612
Country	:	US
Telephone Number	:	516-775-2606
Fax Number	:	516-775-2676

Provider Business Practice Location Address
First Line	:	1205 JERICHO TPKE
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11040-4612
Country	:	US
Telephone Number	:	516-775-2606
Fax Number	:	516-775-2676

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	MRS. BARBARA RUBIN
Credential	:	OPTICIAN
Telephone Number	:	516-775-2606

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	08/22/2020

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