Simon Family Eye Care, Llc | |
14820 W Mayflower Dr New Berlin WI 53151-6716 | |
(262) 227-0542 | |
Not Available |
Full Name | Simon Family Eye Care, Llc |
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Speciality | Clinic/Center |
Location | 14820 W Mayflower Dr, New Berlin, Wisconsin |
Authorized Official Name and Position | Debra Simon (OWNER) |
Authorized Official Contact | 2625997045 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Simon Family Eye Care, Llc 15300 W Grange Ave New Berlin WI 53151-7909 Ph: (262) 599-7045 | Simon Family Eye Care, Llc 14820 W Mayflower Dr New Berlin WI 53151-6716 Ph: (262) 227-0542 |
NPI Number | 1649644543 |
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Provider Enumeration Date | 11/16/2015 |
Last Update Date | 11/16/2015 |
Medicare PECOS PAC ID | 0244518066 |
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Medicare Enrollment ID | O20161031000375 |
Identifier | Type | State | Issuer |
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1649644543 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 2861-035 (Wisconsin) | Primary |
Provider Name | Debra Simon |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1326163122 PECOS PAC ID: 4183781271 Enrollment ID: I20090317000040 |
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