MEDICARE: GAGLIOTI & WEINBERGER OPTOMETRY PRACTICE PC

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

General Provider Information

NPI Number	:	1871393702
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAGLIOTI & WEINBERGER OPTOMETRY PRACTICE PC

Provider Business Mailing Address
First Line	:	20B N SALEM RD
Second Line	:
City	:	CROSS RIVER
State	:	NY
Zip	:	10518-1104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20B N SALEM RD
Second Line	:
City	:	CROSS RIVER
State	:	NY
Zip	:	10518-1104
Country	:	US
Telephone Number	:	914-763-0560
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DANIEL MCCANN
Credential	:	OD
Telephone Number	:	914-763-0560

Provider Enumeration Date	:	03/18/2025
Last Update Date	:	03/18/2025

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