Provider Demographics
NPI:1013011105
Name:OPHTHALMIC CONSULTANTS CORNEAL AND REFRACTIVE SURGERY ASSOCIATES PC
Entity Type:Organization
Organization Name:OPHTHALMIC CONSULTANTS CORNEAL AND REFRACTIVE SURGERY ASSOCIATES PC
Other - Org Name:OPHTHALMIC CONSULTANTS PC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-505-6550
Mailing Address - Street 1:310 EAST 14TH STREET
Mailing Address - Street 2:2ND FLOOR SOUTH BUILDING
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-505-6550
Mailing Address - Fax:212-979-1772
Practice Address - Street 1:310 EAST 14TH STREET
Practice Address - Street 2:2ND FLOOR SOUTH BUILDING
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-505-6550
Practice Address - Fax:212-979-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01759920Medicaid
NYCB1767OtherPALMETTO
NYW9L771Medicare PIN