| Optometry Mobile | |
|
9704 Sutphin Blvd Jamaica NY 11435-4721 | |
| (718) 657-7088 | |
| (718) 657-7092 |
| Full Name | Optometry Mobile |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 9704 Sutphin Blvd, Jamaica, New York |
| Authorized Official Name and Position | Alan J. Wengrofsky (VICE PRESIDENT OF FINANCE AND CFO) |
| Authorized Official Contact | 2125452481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Optometry Mobile 60 Madison Ave Fl 5 New York NY 10010-1600 Ph: (212) 545-2439 | Optometry Mobile 9704 Sutphin Blvd Jamaica NY 11435-4721 Ph: (718) 657-7088 |
| NPI Number | 1023185725 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 01/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023185725 | NPI | - | NPPES |
| 00695941 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (New York) | Primary |
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