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General NPI Number Information
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NPI Number | 1649640558
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Entity Type | Organization
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Legal Business Name | HILLSIDE OPHTHALMOLOGY PC
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 16405 HILLSIDE AVE 2ND FLOOR
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City | JAMAICA
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State | NY
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Zip | 11432-4140
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Country | US
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Telephone | 718-206-2893
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Fax |
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Provider Business Mailing Address
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Address Line | 301 E 64TH ST 2D
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City | NEW YORK
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State | NY
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Zip | 10065-6772
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Country | US
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Telephone | 646-559-2763
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT HONG
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Credential | MD
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Telephone | 917-526-3213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | 252818
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License Number State | NY
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