| Simon Family Eye Care, Llc | |
|
14820 W Mayflower Dr New Berlin WI 53151-6716 | |
| (262) 227-0542 | |
| Not Available |
| Full Name | Simon Family Eye Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14820 W Mayflower Dr, New Berlin, Wisconsin |
| Authorized Official Name and Position | Debra Simon (OWNER) |
| Authorized Official Contact | 2625997045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simon Family Eye Care, Llc 15300 W Grange Ave New Berlin WI 53151-7909 Ph: (262) 599-7045 | Simon Family Eye Care, Llc 14820 W Mayflower Dr New Berlin WI 53151-6716 Ph: (262) 227-0542 |
| NPI Number | 1649644543 |
|---|---|
| Provider Enumeration Date | 11/16/2015 |
| Last Update Date | 11/16/2015 |
| Medicare PECOS PAC ID | 0244518066 |
|---|---|
| Medicare Enrollment ID | O20161031000375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649644543 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2861-035 (Wisconsin) | Primary |
| Provider Name | Debra Simon |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326163122 PECOS PAC ID: 4183781271 Enrollment ID: I20090317000040 |
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