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General NPI Number Information
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NPI Number | 1518092287
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Entity Type | Organization
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Legal Business Name | WHITE PLAINS EYE CARE, P.C.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 15 N BROADWAY STE A
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City | WHITE PLAINS
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State | NY
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Zip | 10601-2214
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Country | US
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Telephone | 914-946-0324
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Fax | 914-946-2270
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Provider Business Mailing Address
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Address Line | 15 N BROADWAY STE A
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City | WHITE PLAINS
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State | NY
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Zip | 10601-2214
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Country | US
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Telephone | 914-946-0324
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Fax | 914-946-2270
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JERRY JED
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Credential | O.D.
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Telephone | 914-946-0324
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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 | TUV003557-1
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License Number State | NY
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