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General NPI Number Information
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NPI Number | 1316072507
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Entity Type | Organization
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Legal Business Name | OCEAN EYE CARE MEDICAL PC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 40 W BRIGHTON AVE STE 103
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City | BROOKLYN
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State | NY
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Zip | 11224-4901
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Country | US
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Telephone | 718-996-2260
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Fax | 718-996-1123
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Provider Business Mailing Address
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Address Line | 40 W BRIGHTON AVE STE 103
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City | BROOKLYN
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State | NY
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Zip | 11224-4901
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Country | US
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Telephone | 718-996-2260
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Fax | 718-996-1123
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANNA LEV BENTSIANOV
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Credential | M.D.
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Telephone | 718-996-2260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 202022
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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