Provider Demographics
NPI:1164779096
Name:LINDYEYECARE OPTOMETRY PLLC
Entity Type:Organization
Organization Name:LINDYEYECARE OPTOMETRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:COSENZA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:631-226-2020
Mailing Address - Street 1:651 N WELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-1635
Mailing Address - Country:US
Mailing Address - Phone:631-226-2020
Mailing Address - Fax:
Practice Address - Street 1:651 N WELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-1635
Practice Address - Country:US
Practice Address - Phone:631-226-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty