Healthcare Provider Details

I. General information

NPI: 1861598567
Provider Name (Legal Business Name): JAY A BEGLEITER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2753 MORELAND ST
YORKTOWN HEIGHTS NY
10598-2420
US

IV. Provider business mailing address

2753 MORELAND ST
YORKTOWN HEIGHTS NY
10598-2420
US

V. Phone/Fax

Practice location:
  • Phone: 914-245-8111
  • Fax:
Mailing address:
  • Phone: 914-245-2521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number003333-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: