MEDICARE: EYEBIZNET, INC.

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	156FX1800X	Optician

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

General Provider Information

NPI Number	:	1942351879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYEBIZNET, INC.

Provider Business Mailing Address
First Line	:	5905 71ST AVE
Second Line	:
City	:	RIDGEWOOD
State	:	NY
Zip	:	11385-5655
Country	:	US
Telephone Number	:	718-386-8900
Fax Number	:	718-386-8400

Provider Business Practice Location Address
First Line	:	5905 71ST AVE
Second Line	:
City	:	RIDGEWOOD
State	:	NY
Zip	:	11385-5655
Country	:	US
Telephone Number	:	718-386-8900
Fax Number	:	718-386-8400

Authorized Official
Title or Position	:	OPTICIAN
Name	:	MR. SCOTT DAVID COHEN
Credential	:	LOD
Telephone Number	:	718-386-8900

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/22/2020

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Directions to “EYEBIZNET, INC. ” Practice Location

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