| |
1802 Kings Hwy, Brooklyn, NY 11229-1308 | |
(718) 376-1420 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist - Optician |
Location | 1802 Kings Hwy, Brooklyn, New York |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1942234273 | NPI | - | NPPES |
00772789 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | TUV004505-1 (New York) | Secondary |
156FX1800X | Technician/technologist - Optician | 004129-1 (New York) | Primary |
Mailing Address | Practice Location Address |
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1802 Kings Hwy, Brooklyn, NY 11229-1308 Ph: (718) 376-1420 | 1802 Kings Hwy, Brooklyn, NY 11229-1308 Ph: (718) 376-1420 |