Provider Demographics
NPI:1003984188
Name:MODERN EYES OPHTHALMOLOGY
Entity Type:Organization
Organization Name:MODERN EYES OPHTHALMOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-579-5400
Mailing Address - Street 1:1 CENTER LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1032
Mailing Address - Country:US
Mailing Address - Phone:516-579-5400
Mailing Address - Fax:516-579-5437
Practice Address - Street 1:3509 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1314
Practice Address - Country:US
Practice Address - Phone:516-579-5400
Practice Address - Fax:516-579-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147635207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCAWRW1Medicare PIN