| Wizard Of Eyes Of 116 St Inc | |
|
187 E 116th St, New York, NY 10029-1342 | |
| (212) 996-7676 | |
| Not Available |
| Full Name | Wizard Of Eyes Of 116 St Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 187 E 116th St, New York, 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 |
|---|---|---|---|
| 1952419053 | NPI | - | NPPES |
| 01181057 | Medicaid | NY | |
| A100133294 | Other | NY | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 156FX1800X | Technician/technologist - Optician | (* (Not Available)) | Secondary |
| Provider Name | Rachel Holzman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861755027 PECOS PAC ID: 2365681244 Enrollment ID: I20130626000098 |
| Provider Name | Shrishyla Yelgar |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801355995 PECOS PAC ID: 0143552562 Enrollment ID: I20191104001730 |
| Provider Name | Eric Sze |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700518081 PECOS PAC ID: 9335595982 Enrollment ID: I20231102001241 |
| Mailing Address | Practice Location Address |
|---|---|
| Wizard Of Eyes Of 116 St Inc 187 E 116th St, New York, NY 10029-1342 Ph: (212) 996-7676 | Wizard Of Eyes Of 116 St Inc 187 E 116th St, New York, NY 10029-1342 Ph: (212) 996-7676 |
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