Healthcare Provider Details
I. General information
NPI: 1336605229
Provider Name (Legal Business Name): LLAMBIRI OPTOMETRIC EYE CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/15/2019
Last Update Date: 03/24/2023
Certification Date: 03/24/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3850 HEMPSTEAD TURNPIKE ATTENTION: TARGET OPTICAL
LEVITTOWN NY
11735-1173
US
IV. Provider business mailing address
10 HEARTHSTONE CT
FARMINGDALE NY
11735-3654
US
V. Phone/Fax
- Phone: 830-357-0736
- Fax:
- Phone: 347-216-1348
- Fax:
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:
DHIMITER
LLAMBIRI
Title or Position: OPTOMETRIST
Credential: OD
Phone: 347-216-1348