Provider Demographics
NPI:1275860413
Name:101 LASIK SURGICAL GROUP
Entity Type:Organization
Organization Name:101 LASIK SURGICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:HAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-505-6550
Mailing Address - Street 1:101 PARK AVE
Mailing Address - Street 2:PLAZA LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10178-0002
Mailing Address - Country:US
Mailing Address - Phone:212-697-0202
Mailing Address - Fax:212-697-0769
Practice Address - Street 1:101 PARK AVE
Practice Address - Street 2:PLAZA LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10178-0002
Practice Address - Country:US
Practice Address - Phone:212-697-0202
Practice Address - Fax:212-697-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery