Individual
DR. MAEDI BARTOLACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
33 W 42ND ST, NEW YORK, NY 10036-8005
(212) 938-4001
(212) 938-5831
Mailing address
33 W 42ND ST, NEW YORK, NY 10036-8005
(212) 938-4001
(212) 938-5831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
007917
NY
152WC0802X
Corneal and Contact Management Optometrist
007917
NY
152WP0200X
Pediatric Optometrist
Primary
007917
NY
152WV0400X
Vision Therapy Optometrist
007917
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00244528
—
NY
01
—
W01551
SUNY GROUP MEDICARE ID#
NY
Enumeration date
08/08/2012
Last updated
08/08/2012
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