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General NPI Number Information
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NPI Number | 1538450192
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Entity Type | Organization
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Legal Business Name | OPHTHALMIC CONSULTANTS OF OPHTHALMOLOGY, PC
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Dates
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Enumeration Date | 04/29/2011
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Last Update Date | 04/29/2011
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Provider Practice Location Address
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Address Line | 940 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0311
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Country | US
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Telephone | 212-570-6300
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Fax | 212-472-4524
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Provider Business Mailing Address
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Address Line | 940 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0311
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Country | US
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Telephone | 212-570-6300
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Fax | 212-472-4524
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONATHAN M KAGAN
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Credential | MD
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Telephone | 212-570-6300
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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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