Provider Demographics
NPI:1255493730
Name:CARVER, EVA (OPTICIAN)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:
Last Name:CARVER
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HATFIELD LN
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6752
Mailing Address - Country:US
Mailing Address - Phone:845-294-5128
Mailing Address - Fax:845-294-1479
Practice Address - Street 1:1 HATFIELD LN
Practice Address - Street 2:SUITE 3
Practice Address - City:GOSHEN
Practice Address - State:NY
Practice Address - Zip Code:10924-6752
Practice Address - Country:US
Practice Address - Phone:845-294-5128
Practice Address - Fax:845-294-1479
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005501-01156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005501-1OtherLICENSE NUMBER
NY005501-1OtherLICENSE NUMBER