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General NPI Number Information
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NPI Number | 1780624494
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Entity Type | Organization
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Legal Business Name | EYECARE OPHTHALMOLOGY PLLC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 792 N MAIN STREET SUITE 200B
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City | NORTH SYRACUSE
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State | NY
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Zip | 13212-1673
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Country | US
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Telephone | 315-634-1190
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Fax | 315-634-1194
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Provider Business Mailing Address
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Address Line | PO BOX 28
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City | SYRACUSE
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State | NY
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Zip | 13214-0028
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Country | US
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Telephone | 315-634-1190
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Fax | 315-634-1194
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Authorized Official
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Title or Position | OWNER
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Name | DR. BARRY RABIN
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Credential | M.D.
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Telephone | 315-634-1190
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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 | 150576
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License Number State | NY
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