Healthcare Provider Details

I. General information

NPI: 1154762045
Provider Name (Legal Business Name): RANDA M GARANA MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 E 55TH ST APT 105
NEW YORK NY
10022-4148
US

IV. Provider business mailing address

305 E 55TH ST APT 105
NEW YORK NY
10022-4148
US

V. Phone/Fax

Practice location:
  • Phone: 212-725-7442
  • Fax:
Mailing address:
  • Phone: 212-725-7442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RANDA M GARRANA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 212-725-7442