| |
2799 Route 112 Ste 2a, King Kullen Shopping Center, Medford, NY 11763-2535 | |
(631) 289-3937 | |
(631) 207-0913 |
Full Name | |
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Type | Facility |
Speciality | Technician/technologist |
Location | 2799 Route 112 Ste 2a, Medford, New York |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982667390 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
156F00000X | Technician/technologist | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
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2921 Erie Blvd East, Syracuse, NY 13224-1430 Ph: (315) 446-3145 | 2799 Route 112 Ste 2a, King Kullen Shopping Center, Medford, NY 11763-2535 Ph: (631) 289-3937 |