| Petrou Eye Care | |
|
7040 N Port Washington Rd Suite 420 Glendale WI 53217-3885 | |
| (414) 839-8379 | |
| Not Available |
| Full Name | Petrou Eye Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 7040 N Port Washington Rd, Glendale, Wisconsin |
| Authorized Official Name and Position | Christina Petrou (OPTOMETRIST) |
| Authorized Official Contact | 4148398379 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petrou Eye Care 7040 N Port Washington Rd Suite 420 Glendale WI 53217-3885 Ph: (414) 839-8379 | Petrou Eye Care 7040 N Port Washington Rd Suite 420 Glendale WI 53217-3885 Ph: (414) 839-8379 |
| NPI Number | 1891068599 |
|---|---|
| Provider Enumeration Date | 02/12/2012 |
| Last Update Date | 02/12/2012 |
| Medicare PECOS PAC ID | 3870756877 |
|---|---|
| Medicare Enrollment ID | O20120530000639 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891068599 | NPI | - | NPPES |
| 385755400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2387-035 (Wisconsin) | Primary |
| Provider Name | Christina M Petrou |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912945338 PECOS PAC ID: 7416920046 Enrollment ID: I20040812001516 |
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