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NPI Code Detail

MEDICARE: ANCONA EYECARE INC

MEDICARE: ANCONA EYECARE 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
1152W00000XOptometristTUV005837NY

General Provider Information

NPI Number : 1700011681
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANCONA EYECARE INC
Provider Business Mailing Address
First Line : 84 FRONT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-1004
Country : US
Telephone Number : 718-422-7800
Fax Number : 718-422-7887
Provider Business Practice Location Address
First Line : 84 FRONT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-1004
Country : US
Telephone Number : 718-422-7800
Fax Number : 718-422-7887
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROBERT J ANCONA
Credential : O.D.
Telephone Number : 718-422-7800
Provider Enumeration Date : 05/21/2009
Last Update Date : 09/12/2009

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Directions to “ANCONA EYECARE INC ” Practice Location

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