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NPI Code Detail

MEDICARE: SHADES OF MONTAGUE

MEDICARE: SHADES OF MONTAGUE
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
1152WC0802XCorneal and Contact Management Optometrist003978NY

General Provider Information

NPI Number : 1720275175
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHADES OF MONTAGUE
Provider Business Mailing Address
First Line : 132 MONTAGUE ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-3521
Country : US
Telephone Number : 718-852-1149
Fax Number : 718-522-4379
Provider Business Practice Location Address
First Line : 132 MONTAGUE ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-3521
Country : US
Telephone Number : 718-852-1149
Fax Number : 718-522-4379
Authorized Official
Title or Position : PRESIDENT
Name : DR. STUART ADDIS FRIEDMAN
Credential : O.D.
Telephone Number : 718-852-1149
Provider Enumeration Date : 10/01/2007
Last Update Date : 02/07/2012

Similar Medicare Providers

1497831846 — DR. STUART ADDIS FRIEDMAN OD
Practice Location Address:
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11201-3521
Practice Phone: 718-852-1149
Practice Fax: 718-522-4379
1912934589 — MS. FELICIA BRIGID FITZPATRICK-LUCEY LCSW
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1548297138 — MRS. NATALIE ANN KABAKOV LMSW
Practice Location Address:
2000 FLATBUSH AVE
BROOKLYN, NY
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Practice Phone: 718-377-5755
Practice Fax: 718-377-0752
1053323592 — MR. ANDREW LABBATE JR. MSPT, ATC
Practice Location Address:
2048 FLATBUSH AVE
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1790845634 — MR. NICK A GOREVIC LMSW
Practice Location Address:
2000 FLATBUSH AVE
BROOKLYN, NY
11234-3521
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Practice Fax:
1689730152 — MS. MARIA THERESA STEHLE LCSW
Practice Location Address:
2000 FLATBUSH AVE
BROOKLYN, NY
11234-3521
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Practice Fax: 718-377-0752

Directions to “SHADES OF MONTAGUE ” Practice Location

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