| Dr.anthony Modesto Od Pc | |
|
385 Route 25a Unit 6, Miller Place, NY 11764-2501 | |
| (631) 642-8400 | |
| (631) 642-8403 |
| Full Name | Dr.anthony Modesto Od Pc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 385 Route 25a Unit 6, Miller Place, 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 |
|---|---|---|---|
| 1750573093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | VUT003195 (New York) | Primary |
| Provider Name | Anthony Modesto |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851478259 PECOS PAC ID: 3274522974 Enrollment ID: I20040507001345 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr.anthony Modesto Od Pc 385 Route 25a Unit 6, Miller Place, NY 11764-2501 Ph: (631) 642-8400 | Dr.anthony Modesto Od Pc 385 Route 25a Unit 6, Miller Place, NY 11764-2501 Ph: (631) 642-8400 |
Nusrat Jahan, OD Optometrist Medicare: Medicare Enrolled Practice Location: 385 Route 25a Unit 6, Miller Place, NY 11764 Phone: 631-642-8400 Fax: 631-642-8403 | |
200 West Optics, Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 385 Route 25a Unit 6, Miller Place, NY 11764 Phone: 631-342-8400 Fax: 631-642-8403 | |
Dr. Anthony Modesto, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 385 Route 25a, Suite 6, Miller Place, NY 11764 Phone: 631-642-8400 Fax: 631-642-8403 |