MEDICARE: J GEORGE OPTICAL COMPANY

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	332B00000X	Durable Medical Equipment & Medical Supplies		NY

General Provider Information

NPI Number	:	1962544932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J GEORGE OPTICAL COMPANY

Provider Business Mailing Address
First Line	:	1523 PINE AVE
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14301-2209
Country	:	US
Telephone Number	:	716-282-7377
Fax Number	:	716-282-7382

Provider Business Practice Location Address
First Line	:	1523 PINE AVE
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14301-2209
Country	:	US
Telephone Number	:	716-282-7377
Fax Number	:	716-282-7382

Authorized Official
Title or Position	:	OPTICIAN OWNER
Name	:	MR. JAMES L FERNANDEZ
Credential	:
Telephone Number	:	716-282-7377

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/21/2022

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