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General NPI Number Information
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NPI Number | 1003014002
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Entity Type | Organization
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Legal Business Name | LIPTON EYECARE
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 141 DIVISION ST
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City | NEW YORK
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State | NY
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Zip | 10002-1000
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Country | US
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Telephone | 212-393-1341
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Fax |
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Provider Business Mailing Address
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Address Line | 141 DIVISION ST
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City | NEW YORK
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State | NY
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Zip | 10002-6143
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Country | US
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Telephone | 212-393-1341
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Fax |
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Authorized Official
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Title or Position | OPHTHALMOLOGIST
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Name | DR. EVAN JAY LIPTON
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Credential | MD
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Telephone | 212-393-1341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1595
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License Number State | NY
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