Healthcare Provider Details

I. General information

NPI: 1215705132
Provider Name (Legal Business Name): FOCUS MEDICAL NY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 FRANKLIN AVE
GARDEN CITY NY
11530-4524
US

IV. Provider business mailing address

7501 PARAGON RD STE 201
DAYTON OH
45459-5323
US

V. Phone/Fax

Practice location:
  • Phone: 516-741-6334
  • Fax:
Mailing address:
  • Phone: 904-545-4465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHRISTA WILLIAMS
Title or Position: DIRECTOR, REVENUE CYCLE MANAGEMENT
Credential:
Phone: 904-312-2295