Healthcare Provider Details

I. General information

NPI: 1750873337
Provider Name (Legal Business Name): WESTCHESTER SQUARE OPHTHALMOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2018
Last Update Date: 02/22/2024
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 BRUCKNER BOULEVARD SUITE 6A
BRONX NY
10461-0396
US

IV. Provider business mailing address

3651 BRUCKNER BOULEVARD SUITE 6A
BRONX NY
10461-0396
US

V. Phone/Fax

Practice location:
  • Phone: 718-823-9227
  • Fax: 646-779-7018
Mailing address:
  • Phone: 718-823-9227
  • Fax: 646-779-7018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number198164
License Number StateNY

VIII. Authorized Official

Name: JONATHAN SHEINDLIN
Title or Position: DIRECTOR
Credential: M.D.
Phone: 718-823-9227