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NPI Code Detail

MEDICARE: OPHTHALMOLOGY ASSOCIATES OF BAY RIDGE, P.C.

MEDICARE: OPHTHALMOLOGY ASSOCIATES OF BAY RIDGE, P.C.
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
1207W00000XOphthalmology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700845567
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPHTHALMOLOGY ASSOCIATES OF BAY RIDGE, P.C.
Provider Business Mailing Address
First Line : 8721 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5109
Country : US
Telephone Number : 718-680-1500
Fax Number : 718-680-5550
Provider Business Practice Location Address
First Line : 8721 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5109
Country : US
Telephone Number : 718-680-1500
Fax Number : 718-680-5550
Authorized Official
Title or Position : PRESIDENT
Name : STEPHEN DAVID CONRAD
Credential : M.D.
Telephone Number : 718-680-1500
Provider Enumeration Date : 03/21/2006
Last Update Date : 05/30/2013

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