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NPI Code Detail

MEDICARE: THE MACKOOL EYE INSTITUTE, LLC

MEDICARE: THE MACKOOL EYE INSTITUTE, LLC
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
1261QS0132XOphthalmologic Surgery Clinic/Center
2261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1851343719
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE MACKOOL EYE INSTITUTE, LLC
Provider Business Mailing Address
First Line : 3127 41ST ST
Second Line :
City : ASTORIA
State : NY
Zip : 11103-3901
Country : US
Telephone Number : 718-728-3400
Fax Number : 718-721-7562
Provider Business Practice Location Address
First Line : 3127 41ST ST
Second Line :
City : ASTORIA
State : NY
Zip : 11103-3901
Country : US
Telephone Number : 718-728-3400
Fax Number : 718-721-7562
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : CHRISTINE KEANE
Credential :
Telephone Number : 718-728-3400
Provider Enumeration Date : 05/17/2006
Last Update Date : 03/25/2025

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Directions to “THE MACKOOL EYE INSTITUTE, LLC ” Practice Location

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