Healthcare Provider Details
I. General information
NPI: 1225735202
Provider Name (Legal Business Name): SEHDEV OPTOMETRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/10/2023
Last Update Date: 12/31/2024
Certification Date: 12/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
258-18 HILLSIDE AVE
GLEN OAKS NY
11004
US
IV. Provider business mailing address
258-08 HILLSIDE AVE
GLEN OAKS NY
11004
US
V. Phone/Fax
- Phone: 718-470-2280
- Fax: 718-470-2524
- Phone: 718-470-2280
- Fax: 718-470-2524
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HARRY
SEHDEV
Title or Position: PRESIDENT
Credential: OD
Phone: 516-830-5275