Healthcare Provider Details

I. General information

NPI: 1518920016
Provider Name (Legal Business Name): EYE CARE OPTOMETRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 06/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27130 77TH AVE
NEW HYDE PARK NY
11040-1446
US

IV. Provider business mailing address

271-30 77TH AVE
NEW HYDE PARK NY
11040
US

V. Phone/Fax

Practice location:
  • Phone: 718-343-1414
  • Fax: 718-343-2578
Mailing address:
  • Phone: 718-343-1414
  • Fax: 718-343-2578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7808
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberTUV004353-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberTUV004353-1
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTUV004353-1
License Number StateNY

VIII. Authorized Official

Name: DR. DANA GETZ
Title or Position: OWNER PRESIDENT
Credential: O.D.
Phone: 718-343-1414