Basic Information
Provider Information
NPI: 1861962144
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAINI
FirstName: HARKIRAT
MiddleName: SINGH
NamePrefix: DR.
NameSuffix:  
Credential: OD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2655 RICHMOND AVE STE 1140
Address2:  
City: STATEN ISLAND
State: NY
PostalCode: 103145852
CountryCode: US
TelephoneNumber: 7187615607
FaxNumber:  
Practice Location
Address1: 2655 RICHMOND AVE STE 1140
Address2:  
City: STATEN ISLAND
State: NY
PostalCode: 103145852
CountryCode: US
TelephoneNumber: 7187615607
FaxNumber: 7187615452
Other Information
ProviderEnumerationDate: 11/29/2018
LastUpdateDate: 12/18/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X008901NYY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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