Healthcare Provider Details

I. General information

NPI: 1780736660
Provider Name (Legal Business Name): BUXTON EYE SURGICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E 14TH ST STE 403
NEW YORK NY
10003-4201
US

IV. Provider business mailing address

310 E 14TH ST STE 403
NEW YORK NY
10003-4201
US

V. Phone/Fax

Practice location:
  • Phone: 212-979-4410
  • Fax: 212-353-5772
Mailing address:
  • Phone: 212-979-4410
  • Fax: 212-353-5772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number156783-1
License Number StateNY

VIII. Authorized Official

Name: DR. DOUGLAS FRANCISCO BUXTON
Title or Position: OPHTHALMOLOGIST
Credential: M.D.
Phone: 212-979-4410