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57 North St, Mexico, NY 13114-4302 | |
(315) 963-8233 | |
(315) 963-7209 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 57 North St, Mexico, 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 |
---|---|---|---|
1104924752 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TUV003386 (New York) | Primary |
152W00000X | Optometrist | TUV006428 (New York) | Secondary |
Provider Name | Brandi S Coleman |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932275898 PECOS PAC ID: 3375435969 Enrollment ID: I20040329000086 |
Mailing Address | Practice Location Address |
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57 North St, Po Box 368, Mexico, NY 13114-4302 Ph: (315) 963-8233 | 57 North St, Mexico, NY 13114-4302 Ph: (315) 963-8233 |
Dr. Brandi S. Coleman, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 3277 Main St., Mexico, NY 13114 Phone: 315-963-8233 |