Healthcare Provider Details

I. General information

NPI: 1366491268
Provider Name (Legal Business Name): EYAL MARGALIT MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 CHALAN SAN ANTONIO SUITE 214
TAMUNING GU
96913
US

IV. Provider business mailing address

12756 NICHOLAS ST
OMAHA NE
68154-1278
US

V. Phone/Fax

Practice location:
  • Phone: 671-647-5382
  • Fax: 671-647-5385
Mailing address:
  • Phone: 671-647-5382
  • Fax: 671-647-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberM-1878
License Number StateGU

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: