Individual
DR. NORMAN BRET MEDOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3332 ROCHAMBEAU AVE, ROOM 306, BRONX, NY 10467-2836
(718) 920-4609
(718) 881-5439
Mailing address
111 E 210TH STREET, MONTEFIORE MEDICAL CENTER DEPARTMENT OF OPHTHALMOLOGY, BRONX, NY 10467
(718) 920-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
099393
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00169791
—
NY
01
—
05710P
HIP
NY
01
—
132760994
GUARDIAN PHCS
NY
01
—
181922385
R.R. MEDICARE
NY
01
—
2127300
AETNA USHEALTHCARE
NY
01
—
P2073780
OXFORD
NY
Enumeration date
07/14/2005
Last updated
04/25/2012
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