MEDICARE: HEUER OPTICAL

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	27202010	NY

General Provider Information

NPI Number	:	1891013546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEUER OPTICAL

Provider Business Mailing Address
First Line	:	458 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-6027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	458 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-6027
Country	:	US
Telephone Number	:	212-696-5990
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MICHAEL THOMAS
Credential	:	O.D.
Telephone Number	:	212-696-5990

Provider Enumeration Date	:	05/05/2010
Last Update Date	:	05/05/2010

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Directions to “HEUER OPTICAL ” Practice Location

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