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General NPI Number Information
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NPI Number | 1841410495
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Entity Type | Organization
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Legal Business Name | SURGICAL EYE CARE PLLC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/30/2008
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Provider Practice Location Address
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Address Line | 86 MAIN ST
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City | SARANAC LAKE
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State | NY
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Zip | 12983-5736
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Country | US
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Telephone | 518-891-5189
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Fax | 518-891-1992
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Provider Business Mailing Address
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Address Line | 86 MAIN ST
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City | SARANAC LAKE
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State | NY
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Zip | 12983-5736
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Country | US
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Telephone | 518-891-5189
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Fax | 518-891-1992
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DELPHINE S WINTER
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Credential |
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Telephone | 518-891-5189
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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 | 168303
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License Number State | NY
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