MEDICARE: GENERAL OPHTHALMOLOGY, P.C

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	207W00000X	Ophthalmology Physician	245002	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1831482082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERAL OPHTHALMOLOGY, P.C

Provider Business Mailing Address
First Line	:	6373 108TH ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1607
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6373 108TH ST
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1607
Country	:	US
Telephone Number	:	718-896-2020
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LEON ALEKSANDROVICH
Credential	:	M.D
Telephone Number	:	718-896-2020

Provider Enumeration Date	:	05/20/2011
Last Update Date	:	05/20/2011

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