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General NPI Number Information
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NPI Number | 1194964924
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Entity Type | Organization
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Legal Business Name | PRABJOT CHANNA, EYE PHYSICIAN AND SURGEON PLLC
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 700 WHITE PLAINS RD SUITE 28,
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City | SCARSDALE
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State | NY
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Zip | 10583-5063
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Country | US
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Telephone | 914-472-5140
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Fax | 914-472-5270
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Provider Business Mailing Address
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Address Line | PO BOX 177
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City | SCARSDALE
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State | NY
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Zip | 10583-0177
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Country | US
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Telephone | 914-924-3359
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Fax | 914-478-1287
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PRABJOT CHANNA
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Credential | M.D.
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Telephone | 914-413-3681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 223857-1
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License Number State | NY
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