OrganizationJohn A. Facchin, O.D.Durable Medical Equipment & Medical SuppliesSuppliersPractice Address111 Grand Ave, Massapequa, NY 11758-4905(516) 798-2635(516) 220-7787PECOS EnrollmentBased on the most recent information from CMS, provider John A. Facchin, O.D. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1871776450Provider TypeOrganizationFull NameJohn A. Facchin, O.D.SubpartNoEnumeration Date12/6/2007Last Updated11/5/2008Contact InformationPractice LocationPractice Address111 Grand Ave, Massapequa, NY 11758-4905Phone(516) 798-2635FaxUnlisted FaxMailing LocationMailing Address1 Maple St, Massapequa, NY 11758-5718Phone(516) 220-7787FaxUnlisted FaxAuthorized OfficialNameFacchin, John A. (Sole Proprietor)Phone(516) 798-2635Provider TaxonomiesCodeDescriptionLicenseCode332B00000XPrimaryDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicense0978400001New YorkProvider IdentifiersIDDescriptionIssuerID01474419DescriptionMedicaidIssuerUnlistedNew York