| Tristate Optometry Pllc | |
|
839 E 149th St, Bronx, NY 10455-4662 | |
| (718) 576-1993 | |
| (718) 576-1996 |
| Full Name | Tristate Optometry Pllc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 839 E 149th St, 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 |
|---|---|---|---|
| 1952175911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Kelvin Peralta |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376097477 PECOS PAC ID: 5597049155 Enrollment ID: I20170227000406 |
| Provider Name | John Tao |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194177493 PECOS PAC ID: 6507124930 Enrollment ID: I20171213000467 |
| Mailing Address | Practice Location Address |
|---|---|
| Tristate Optometry Pllc 839 E 149th St, Bronx, NY 10455-4662 Ph: (718) 576-1993 | Tristate Optometry Pllc 839 E 149th St, Bronx, NY 10455-4662 Ph: (718) 576-1993 |
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