MEDICARE: DR. TAT-WAI MICHAEL HO O.D.

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	005483	NY

General Provider Information

NPI Number	:	1861539264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAT-WAI MICHAEL HO O.D.

Provider Business Mailing Address
First Line	:	2 BAY CLUB DR APT 19G
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11360-2932
Country	:	US
Telephone Number	:	718-225-1074
Fax Number	:

Provider Business Practice Location Address
First Line	:	13620 38TH AVE STE 7D
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-4232
Country	:	US
Telephone Number	:	718-321-0355
Fax Number	:

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	03/17/2018

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