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General NPI Number Information
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NPI Number | 1366455339
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Entity Type | Organization
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Legal Business Name | EYE PHYSICIANS AND SURGEONS OF NY, PLLC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 11/05/2007
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Provider Practice Location Address
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Address Line | 2177 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6603
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Country | US
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Telephone | 718-494-9055
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Fax | 718-494-3713
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Provider Business Mailing Address
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Address Line | 149 PIERREPONT ST
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City | BROOKLYN
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State | NY
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Zip | 11201-2712
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Country | US
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Telephone | 718-834-1976
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Fax | 718-855-8567
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. IRIS A JORDAN
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Credential | R.N., M.S.
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Telephone | 718-834-1976
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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 |
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License Number State |
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