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General NPI Number Information
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NPI Number | 1780738351
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Entity Type | Organization
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Legal Business Name | TREMONT EYE CARE SPECIFICS, INC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 25 E 233RD STREET
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City | BRONX
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State | NY
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Zip | 10470-2207
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Country | US
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Telephone | 718-405-7211
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Fax | 718-405-7599
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Provider Business Mailing Address
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Address Line | 25 E 233RD STREET
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City | BRONX
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State | NY
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Zip | 10470-2207
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Country | US
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Telephone | 718-405-7211
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Fax | 718-405-7599
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AUSTIN MATTHEW CIAZ WHITE
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Credential | OD
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Telephone | 718-405-7211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | VUT5575
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License Number State | NY
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