Healthcare Provider Details

I. General information

NPI: 1922775535
Provider Name (Legal Business Name): HARRY SEHDEV OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2021
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

39 BLANCHE ST
PLAINVIEW NY
11803-4621
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-2280
  • Fax:
Mailing address:
  • Phone: 516-830-5275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTRO-009367
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: