Individual
BETH A REALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T005235
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01436039
—
NY
01
—
101990
HMO PREFERRED CARE
NY
01
—
122289
COLE MANAGED CARE
—
01
—
NY5235
EYE MED
—
01
—
P010005235
BLUE CHOICE HMO
NY
Enumeration date
12/09/2005
Last updated
01/27/2016
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