| Svc Of Coram Llc | |
|
1721 N Ocean Ave Ste A, Medford, NY 11763-2684 | |
| (631) 732-0822 | |
| (631) 732-0018 |
| Full Name | Svc Of Coram Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1721 N Ocean Ave Ste A, Medford, 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 |
|---|---|---|---|
| 1619411972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 332H00000X | Eyewear Supplier | (* (Not Available)) | Secondary |
| Provider Name | Theresa Loscalzo Bacaris |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720162431 PECOS PAC ID: 8224076492 Enrollment ID: I20050419000484 |
| Provider Name | Jeffrey Slaney Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225024490 PECOS PAC ID: 6901813310 Enrollment ID: I20060309000442 |
| Provider Name | Jeffrey Slaney Williams |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396945143 PECOS PAC ID: 3870687593 Enrollment ID: I20071108000578 |
| Provider Name | Monika Murawska |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891950143 PECOS PAC ID: 4688722309 Enrollment ID: I20090506000188 |
| Provider Name | Cynthia Wiener |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063896926 PECOS PAC ID: 5890088306 Enrollment ID: I20160721000489 |
| Provider Name | Preeti K Minhas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447744263 PECOS PAC ID: 9739437575 Enrollment ID: I20180809005581 |
| Provider Name | Jin Yip Chiu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104469287 PECOS PAC ID: 5092149179 Enrollment ID: I20191224000176 |
| Provider Name | Renu Tyagaraj |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851944748 PECOS PAC ID: 7810315298 Enrollment ID: I20200916003042 |
| Provider Name | Michelle Anne Mckillop |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851917256 PECOS PAC ID: 4880012137 Enrollment ID: I20200917002798 |
| Provider Name | Ava Louise Koch |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275143075 PECOS PAC ID: 8628488152 Enrollment ID: I20201111002181 |
| Provider Name | Gina Nicole Dericco |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588287312 PECOS PAC ID: 3577974658 Enrollment ID: I20201120001128 |
| Provider Name | Alicia Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437776960 PECOS PAC ID: 1759796907 Enrollment ID: I20210219002351 |
| Provider Name | Raazia Syedda |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386217974 PECOS PAC ID: 3779987391 Enrollment ID: I20210804001999 |
| Provider Name | Gurkiran Kaur |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144957366 PECOS PAC ID: 6305221904 Enrollment ID: I20220919000746 |
| Provider Name | Paige M Thomas |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861166035 PECOS PAC ID: 2264817725 Enrollment ID: I20220920000213 |
| Provider Name | Bryan Sookoo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467010173 PECOS PAC ID: 0345651121 Enrollment ID: I20221123001113 |
| Mailing Address | Practice Location Address |
|---|---|
| Svc Of Coram Llc 1224 Ostrander Avenue, Riverhead, NY 11901 Ph: (631) 727-2858 | Svc Of Coram Llc 1721 N Ocean Ave Ste A, Medford, NY 11763-2684 Ph: (631) 732-0822 |
Dr. Giuseppina M Russo, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2799 Rt 112, Davis Vision At King Kuhlen Shopping Center, Medford, NY 11763 Phone: 631-289-3937 Fax: 631-207-0913 | |
Dr. Jodi Y Corley, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2799 Route 112, Davis Vision King Kullen Shopping Center, Medford, NY 11763 Phone: 631-289-3937 Fax: 631-209-0913 | |
Dr. Steven I Goodman, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1643 Route 112 Ste A, Medford, NY 11763 Phone: 631-758-5575 Fax: 631-758-5579 | |
Dr. Myron P Berlaft, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2799 Rte 112, Davis Vision King Kallen Shopping Center, Medford, NY 11763 Phone: 631-289-3939 Fax: 631-209-0913 | |
Empire Vision Center Inc Optometrist Medicare: Medicare Enrolled Practice Location: 2799 Route 112 Ste 2a, King Kullen Shopping Center, Medford, NY 11763 Phone: 631-289-3937 Fax: 631-207-0913 | |
Steven I Goodman Od Pc Optometrist Medicare: Medicare Enrolled Practice Location: 1643 Route 112 Ste A, Medford, NY 11763 Phone: 631-758-5575 Fax: 631-758-5579 |