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General NPI Number Information
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NPI Number | 1629222641
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Entity Type | Organization
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Legal Business Name | GLAUCOMA ASSOCIATES OF NEW YORK, P.C.
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 121 E 60TH ST
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City | NEW YORK
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State | NY
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Zip | 10022-1117
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Country | US
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Telephone | 212-477-7540
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Fax |
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Provider Business Mailing Address
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Address Line | 310 E 14TH ST SUITE 304 SO
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City | NEW YORK
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State | NY
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Zip | 10003-4201
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Country | US
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Telephone | 646-521-0264
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | SERKADIS ABEBE
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Credential |
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Telephone | 212-477-7540
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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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