Healthcare Provider Details

I. General information

NPI: 1548180276
Provider Name (Legal Business Name): FORDHAM OPTOMETRY AND OPHTHALMIC DISPENSING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E FORDHAM RD
BRONX NY
10468-5404
US

IV. Provider business mailing address

125 E FORDHAM RD
BRONX NY
10468-5404
US

V. Phone/Fax

Practice location:
  • Phone: 718-329-2020
  • Fax: 718-561-0616
Mailing address:
  • Phone: 718-329-2020
  • Fax: 718-561-0616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: ELENA FELDMAN
Title or Position: MEMBER
Credential: OD
Phone: 347-842-8871