MEDICARE: ERIC DESSNER MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	250306-2	NY

General Provider Information

NPI Number	:	1427486083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC DESSNER MD PC

Provider Business Mailing Address
First Line	:	PO BOX 22225
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11202-2225
Country	:	US
Telephone Number	:	718-865-8159
Fax Number	:

Provider Business Practice Location Address
First Line	:	297 MARCUS GARVEY BLVD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11221-1114
Country	:	US
Telephone Number	:	718-865-8159
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIC DESSNER
Credential	:	MD
Telephone Number	:	718-865-8159

Provider Enumeration Date	:	10/17/2013
Last Update Date	:	10/17/2013

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