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NPI Code Detail

MEDICARE: VZ OPTICAL

MEDICARE: VZ 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
1152W00000XOptometristTUV003411-1NY

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 : 1790859874
Entity Type Code : Organization
Provider Name (Legal Business Name) : VZ OPTICAL
Provider Business Mailing Address
First Line : 2655 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5821
Country : US
Telephone Number : 718-698-6666
Fax Number : 718-698-0223
Provider Business Practice Location Address
First Line : 2655 RICHMOND AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-5821
Country : US
Telephone Number : 718-698-6666
Fax Number : 718-698-0223
Authorized Official
Title or Position : ASSISTANT
Name : MICHELLE ERICKSEN
Credential :
Telephone Number : 718-698-6666
Provider Enumeration Date : 11/20/2006
Last Update Date : 01/15/2013

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Directions to “VZ OPTICAL ” Practice Location

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