Healthcare Provider Details

I. General information

NPI: 1578661575
Provider Name (Legal Business Name): MADISON AVENUE EYE CARE LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 LEXINGTON AVE RM 1102
NEW YORK NY
10017-0966
US

IV. Provider business mailing address

370 LEXINGTON AVE RM 1102
NEW YORK NY
10017-0966
US

V. Phone/Fax

Practice location:
  • Phone: 212-687-2054
  • Fax: 212-922-1741
Mailing address:
  • Phone: 212-687-2054
  • Fax: 212-922-1741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ALAN E. KURFIRST
Title or Position: PRESIDENT
Credential: O.D.
Phone: 212-687-2054