MEDICARE: DR. MICHAEL LAMONICA 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	VUT005007-1	NY

General Provider Information

NPI Number	:	1861471609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LAMONICA OD

Provider Business Mailing Address
First Line	:	500 W MAIN ST
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-3027
Country	:	US
Telephone Number	:	631-957-3355
Fax Number	:	631-957-4378

Provider Business Practice Location Address
First Line	:	500 W MAIN ST
Second Line	:	#210
City	:	BABYLON
State	:	NY
Zip	:	11702-3027
Country	:	US
Telephone Number	:	631-957-3355
Fax Number	:	631-957-4378

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	04/16/2014

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