Arthur W Mruczek Sr., MD

Individual provider Active NPI Ophthalmology Physician · Medina, NY

NPI 1124097878 · NPPES record last updated Jun 5, 2008

Key facts

NPI
1124097878
Entity type
Individual (NPI type 1)
Primary specialty
Ophthalmology Physician 207W00000X
License
120403 (NY)
Practice address
500 Erie Street South
Lake Plains Eye Center
Medina, NY 14103
Phone
(585) 798-2020
Fax
(585) 798-3365
NPI assigned
Mar 15, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 120403 NY Yes

Addresses

Primary practice location

500 Erie Street South
Lake Plains Eye Center
Medina, NY 14103

Mailing address

500 Erie Street South
Lpec Medical Eye Care PLLC
Medina, NY 14103
Phone (585) 798-2020

Other identifiers

IdentifierTypeStateIssuer
P020120403OtherNYBLUE CHOICE
100689CROtherNYPREFERRED CARE
P017812763OtherNYBLUE CHOICE
00010122705OtherNYUNIVERA
060905000047OtherNYFIDELIS
00466862MedicaidNY

Other providers in Medina, NY

All providers in Medina, NY · Ophthalmology Physician in New York

Sources for this page

Verify at the official NPI Registry.