Provider Demographics
NPI:1093053381
Name:NORTH COUNTRY EC LLC
Entity Type:Organization
Organization Name:NORTH COUNTRY EC LLC
Other - Org Name:THE NEW YORK EYE SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:518-580-0553
Mailing Address - Street 1:465 MAPLE AVE
Mailing Address - Street 2:UNIT B
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5531
Mailing Address - Country:US
Mailing Address - Phone:518-580-0553
Mailing Address - Fax:518-580-0557
Practice Address - Street 1:135 NORTH RD
Practice Address - Street 2:BUILDING #2
Practice Address - City:WILTON
Practice Address - State:NY
Practice Address - Zip Code:12831-1308
Practice Address - Country:US
Practice Address - Phone:518-580-0553
Practice Address - Fax:518-580-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2357521261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical