Healthcare Provider Details

I. General information

NPI: 1669427068
Provider Name (Legal Business Name): EYE SURGERY CENTER OF WESTCHESTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 PELHAMDALE AVE
NEW ROCHELLE NY
10801-1032
US

IV. Provider business mailing address

838 PELHAMDALE AVE
NEW ROCHELLE NY
10801-1032
US

V. Phone/Fax

Practice location:
  • Phone: 914-576-9600
  • Fax: 914-576-7875
Mailing address:
  • Phone: 914-576-9600
  • Fax: 914-576-7875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number5904203R
License Number StateNY

VIII. Authorized Official

Name: JAY LIPPMAN
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 914-576-9600