Basic Information
| Provider Information | |||||||||
| NPI: | 1093001414 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMERGENCY OPTHAMOLOGY SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 PARK AVE | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100657369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2128329228 | ||||||||
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| Address1: | 550 PARK AVE | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100657369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142891559 | ||||||||
| FaxNumber: | 7142890280 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2011 | ||||||||
| LastUpdateDate: | 06/23/2011 | ||||||||
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| AuthorizedOfficialLastName: | FROMER | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7142891559 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 174683-1 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.