Dr.anthony Modesto Od PC

NPI #1750573093 in Miller Place, New York

Provider Information

NPI Number: 1750573093
Entity Type: Organization
Organization Name: Dr.anthony Modesto Od PC
Primary Specialty: Optometrist
Enumeration Date: Aug 10, 2007
Last Updated: May 27, 2008

Practice Location

Address: 385 ROUTE 25A UNIT 6
City: Miller Place
State: New York
ZIP Code: 11764-2501
Phone: (631) 642-8400

Authorized Official

Name: DR. ANTHONY MODESTO, OD
Title: OPTOMETRIST/PRESIDENT
Phone: (631) 642-8400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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