Provider Demographics
NPI:1093905192
Name:ROBERT R. DITKOFF, M.D., P.C.
Entity Type:Organization
Organization Name:ROBERT R. DITKOFF, M.D., P.C.
Other - Org Name:PARK AVENUE EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:DITKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-772-2800
Mailing Address - Street 1:755 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4255
Mailing Address - Country:US
Mailing Address - Phone:212-772-2800
Mailing Address - Fax:212-772-9220
Practice Address - Street 1:755 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4255
Practice Address - Country:US
Practice Address - Phone:212-772-2800
Practice Address - Fax:212-772-9220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT R. DITKOFF, M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-26
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30876Medicare PIN