Organization
GRACE EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WIDAD ARTAGRACE VALME OD (OPTOMETRIST)
(719) 826-2020
Entity
Organization
Contact information
Practice address
1615 CORTELYOU RD, BROOKLYN, NY 11226-5209
(718) 826-2020
Mailing address
1615 CORTELYOU RD, BROOKLYN, NY 11226-5209
(718) 826-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV006890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C478C1
EMPIRE BLUE CROSS BLUE SHIELD
NY
01
—
P3686293
OXFORD
NY
Enumeration date
04/16/2009
Last updated
04/08/2010
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