MEDICARE: DR. ANDREW TRESSER OD

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	152W00000X	Optometrist	3141	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9146353700	OTHER	NY	VSP
2	355	OTHER	NY	DAVIS
3	P3028020	OTHER	NY	OXFORD
4	597113	OTHER	NY	MVP
5	LD	OTHER	NY	GVS

General Provider Information

NPI Number	:	1861454340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW TRESSER OD

Provider Business Mailing Address
First Line	:	PO BOX 666
Second Line	:
City	:	PLEASANT VALLEY
State	:	NY
Zip	:	12569-0666
Country	:	US
Telephone Number	:	845-635-3700
Fax Number	:	845-635-8317

Provider Business Practice Location Address
First Line	:	1539 MAIN ST
Second Line	:
City	:	PLEASANT VALLEY
State	:	NY
Zip	:	12569-7834
Country	:	US
Telephone Number	:	845-635-3700
Fax Number	:	845-635-8317

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	08/04/2010

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