Basic Information
| Provider Information | |||||||||
| NPI: | 1093851685 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NYE | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 334 CORTELYOU AVENUE | ||||||||
| Address2: | |||||||||
| City: | STATEN ISLAND | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189845867 | ||||||||
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| Practice Location | |||||||||
| Address1: | 482 86TH STREET | ||||||||
| Address2: | LAMS LAB EXPRESS | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112094708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189215488 | ||||||||
| FaxNumber: | 7182382148 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | TUV0036651 | NY | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.