MEDICARE: DR. DAVID C 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	TUV005611-1	NY
2	152W00000X	Optometrist	OA005635	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	T005611	OTHER	NY	OPTOMETRY LICENSE NUMBER
3	OA005635	OTHER	NJ	OPTOMETRY LICENSE NUMBER

General Provider Information

NPI Number	:	1922218528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID C HO O.D.

Provider Business Mailing Address
First Line	:	1825 PARK AVE FRNT
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1932
Country	:	US
Telephone Number	:	212-360-7422
Fax Number	:	212-360-7969

Provider Business Practice Location Address
First Line	:	2058 LEXINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1732
Country	:	US
Telephone Number	:	917-304-9582
Fax Number	:	212-360-7969

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	11/16/2022

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Directions to “ DR. DAVID C HO O.D.” Practice Location

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