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NPI Code Detail

MEDICARE: YOUR OPTICAL

MEDICARE: YOUR OPTICAL
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
1156FX1800XOptician007320NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700955382
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUR OPTICAL
Provider Business Mailing Address
First Line : 2849 W 8TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11224-3604
Country : US
Telephone Number : 718-265-1100
Fax Number :
Provider Business Practice Location Address
First Line : 2849 W 8TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11224-3604
Country : US
Telephone Number : 718-265-1100
Fax Number :
Authorized Official
Title or Position : OPTICIAN
Name : MR. MARAT SHLIMOV
Credential :
Telephone Number : 17182651100
Provider Enumeration Date : 11/07/2006
Last Update Date : 04/23/2008

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Directions to “YOUR OPTICAL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.