Healthcare Provider Details

I. General information

NPI: 1699873067
Provider Name (Legal Business Name): NEW YORK EYE SURGERY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 PELHAM PKWY N
BRONX NY
10469-5411
US

IV. Provider business mailing address

1101 PELHAM PKWY N
BRONX NY
10469-5411
US

V. Phone/Fax

Practice location:
  • Phone: 718-519-1000
  • Fax:
Mailing address:
  • Phone: 718-519-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. GERARD SCALERA
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-519-1000