Dr Michael James Mcgovern, OD | |
624 Hawkins Ave, Suite #1, Lake Ronkonkoma, NY 11779-2324 | |
(631) 588-5100 | |
Not Available |
Full Name | Dr Michael James Mcgovern |
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Gender | Male |
Speciality | Optometrist |
Location | 624 Hawkins Ave, Lake Ronkonkoma, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669470530 | NPI | - | NPPES |
01870373 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TUV5891 (New York) | Primary |
152W00000X | Optometrist | OD2344 (Tennessee) | Secondary |
Provider Name | State Of New York Comptrollers Office |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1407829856 PECOS PAC ID: 0840101770 Enrollment ID: O20040514000118 |
Mailing Address | Practice Location Address |
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Dr Michael James Mcgovern, OD 624 Hawkins Ave, Suite 1, Lake Ronkonkoma, NY 11779-2324 Ph: (631) 588-5100 | Dr Michael James Mcgovern, OD 624 Hawkins Ave, Suite #1, Lake Ronkonkoma, NY 11779-2324 Ph: (631) 588-5100 |
Vanessa Rose Eger, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 388 Hawkins Ave Ste 2, Lake Ronkonkoma, NY 11779 Phone: 631-588-7004 | |
Tracy Rossi, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 624 Hawkins Ave Ste 1, Lake Ronkonkoma, NY 11779 Phone: 631-588-5100 Fax: 631-588-5185 | |
Dr. Tracy K Brooks, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 388 Hawkins Ave Ste 2, Lake Ronkonkoma, NY 11779 Phone: 631-588-7004 Fax: 631-588-2612 | |
Michele Espinosa, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 388 Hawkins Ave, Suite 2, Lake Ronkonkoma, NY 11779 Phone: 631-588-7004 | |
Sachem Eye Care Optometrist Medicare: Medicare Enrolled Practice Location: 388 Hawkins Ave, Suite 2, Lake Ronkonkoma, NY 11779 Phone: 631-588-7004 Fax: 631-588-2612 | |
Frank Thomas Adam, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 500 Portion Rd, Suite 10, Lake Ronkonkoma, NY 11779 Phone: 631-648-9488 Fax: 631-676-4861 |