Provider Demographics
NPI:1265645212
Name:MANHASSET EYE PHYSICIANS, P.C.
Entity Type:Organization
Organization Name:MANHASSET EYE PHYSICIANS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:D'ARIENZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-627-0146
Mailing Address - Street 1:1615 NORTHERN BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3033
Mailing Address - Country:US
Mailing Address - Phone:516-627-0146
Mailing Address - Fax:516-365-4750
Practice Address - Street 1:1615 NORTHERN BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3033
Practice Address - Country:US
Practice Address - Phone:516-627-0146
Practice Address - Fax:516-365-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY187507174400000X
NY180111174400000X
NY097435174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01592103Medicaid
NY00164172Medicaid
NY01613125Medicaid
NYB80011Medicare UPIN
NYF34642Medicare UPIN
NY00164172Medicaid
NY76K721Medicare ID - Type Unspecified
NY958831Medicare PIN
NYF96417Medicare UPIN