| Bright Eyes Vision Care | |
|
12221a Guy R Brewer Blvd Jamaica NY 11434-2406 | |
| (718) 527-0550 | |
| (718) 527-0546 |
| Full Name | Bright Eyes Vision Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 12221a Guy R Brewer Blvd, Jamaica, New York |
| Authorized Official Name and Position | Lisa T Kirkland (DIRECTOR) |
| Authorized Official Contact | 7185270550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bright Eyes Vision Care 830 Elice Pl Baldwin NY 11510-3903 Ph: (917) 209-3713 | Bright Eyes Vision Care 12221a Guy R Brewer Blvd Jamaica NY 11434-2406 Ph: (718) 527-0550 |
| NPI Number | 1053585943 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 03/07/2022 |
| Medicare PECOS PAC ID | 4183764145 |
|---|---|
| Medicare Enrollment ID | O20091223000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053585943 | NPI | - | NPPES |
| 01608319 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | VUT005701 (New York) | Primary |
| Provider Name | Lisa T Kirkland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104801802 PECOS PAC ID: 3072653211 Enrollment ID: I20091218000050 |
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