Provider Demographics
NPI:1083682868
Name:PURVIN, ARTHUR MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:MICHAEL
Last Name:PURVIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E. MERRICK RD
Mailing Address - Street 2:SUIT 01
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6105
Mailing Address - Country:US
Mailing Address - Phone:516-825-7455
Mailing Address - Fax:516-825-1494
Practice Address - Street 1:10 E. MERRICK RD.
Practice Address - Street 2:SUITE 201
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6105
Practice Address - Country:US
Practice Address - Phone:516-825-7455
Practice Address - Fax:516-825-1494
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003478-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT81474Medicare UPIN
NYC2950CFAE1Medicare ID - Type Unspecified