104th St Optical Inc is a
Eyewear Supplier based in New York, New York. 104th St Optical Inc is licensed to practice in * (Not Available) (license number ) and their current practice location is
1884 3rd Ave, New York, New York. It can be reached at their office (for appointments etc.) via phone at
(212) 831-4733.
NPI number for 104th St Optical Inc is 1033278544 and their current mailing address is 1884 3rd Ave, New York, New York. 104th St Optical Inc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1033278544.
Healthcare Provider's Profile
| Full Name | 104th St Optical Inc |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 1884 3rd Ave, New York, New York |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1033278544
- Provider Enumeration Date: 12/08/2006
- Last Update Date: 08/22/2020
Medical Identifiers
Medical identifiers for 104th St Optical Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033278544 | NPI | - | NPPES |
| 59C0310 | Other | NY | COMMUNITY PREMIER PLUS |
| 02687667 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. 104th St Optical Inc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
104th St Optical Inc
1884 3rd Ave,
New York, NY 10029
Ph: (212) 831-4733 | 104th St Optical Inc
1884 3rd Ave,
New York, NY 10029
Ph: (212) 831-4733 |
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