Myron P Berlaft, OD
Individual provider Active NPI Optometrist · Medford, NY
NPI 1619928751 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1619928751
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- T0031641 (NY)
- Practice address
- 2799 Rte 112
Davis Vision King Kallen Shopping Center
Medford, NY 11763 - Phone
- (631) 289-3939
- Fax
- (631) 209-0913
- NPI assigned
- May 13, 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T0031641 | NY | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T0031641 | NY | Yes |
Addresses
Primary practice location
2799 Rte 112
Davis Vision King Kallen Shopping Center
Medford, NY 11763
Mailing address
2921 Erie Blvd E
Syracuse, NY 13224
Phone (315) 445-7465
Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.