| New York Optical Group Inc | |
|
1 E Kingsbridge Rd, Bronx, NY 10468-7501 | |
| (718) 550-2020 | |
| Not Available |
| Full Name | New York Optical Group Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1 E Kingsbridge Rd, Bronx, 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 |
|---|---|---|---|
| 1093408486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Thomas Raphael Dibenedetto |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548885932 PECOS PAC ID: 5890106181 Enrollment ID: I20201117001612 |
| Mailing Address | Practice Location Address |
|---|---|
| New York Optical Group Inc 1 E Kingsbridge Rd, Bronx, NY 10468-7501 Ph: (718) 550-2020 | New York Optical Group Inc 1 E Kingsbridge Rd, Bronx, NY 10468-7501 Ph: (718) 550-2020 |
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