Healthcare Provider Details

I. General information

NPI: 1851343719
Provider Name (Legal Business Name): THE MACKOOL EYE INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3127 41ST ST
ASTORIA NY
11103-3901
US

IV. Provider business mailing address

3127 41ST ST
ASTORIA NY
11103-3901
US

V. Phone/Fax

Practice location:
  • Phone: 718-728-3400
  • Fax: 718-721-7562
Mailing address:
  • Phone: 718-728-3400
  • Fax: 718-721-7562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE KEANE
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 718-728-3400