MEDICARE: EAGLE'S OPTICS 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	156FX1800X	Optician

General Provider Information

NPI Number	:	1700422912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAGLE'S OPTICS INC.

Provider Business Mailing Address
First Line	:	4128 MAIN ST # 7
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-3177
Country	:	US
Telephone Number	:	718-358-8518
Fax Number	:

Provider Business Practice Location Address
First Line	:	4128 MAIN ST # 7
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-3177
Country	:	US
Telephone Number	:	718-358-8518
Fax Number	:

Authorized Official
Title or Position	:	MENGER
Name	:	MR. JIMMY YEUNG
Credential	:
Telephone Number	:	718-358-8518

Provider Enumeration Date	:	11/22/2019
Last Update Date	:	11/22/2019

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Directions to “EAGLE'S OPTICS INC. ” Practice Location

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