Healthcare Provider Details

I. General information

NPI: 1013809565
Provider Name (Legal Business Name): MAYA ELBEIALY MEKAWY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1258 6TH AVE
NEW YORK NY
10020-1511
US

IV. Provider business mailing address

233 SPRING ST FL 6
NEW YORK NY
10013-1522
US

V. Phone/Fax

Practice location:
  • Phone: 646-670-2236
  • Fax:
Mailing address:
  • Phone: 646-670-2236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number011229
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: