Provider Demographics
NPI:1346600624
Name:PANOYAN, ANI (OD)
Entity Type:Individual
Prefix:DR
First Name:ANI
Middle Name:
Last Name:PANOYAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GARDEN CITY PLAZA STE 130
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-741-3063
Mailing Address - Fax:516-741-3137
Practice Address - Street 1:200 GARDEN CITY PLAZA STE 130
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-741-3063
Practice Address - Fax:516-741-3137
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008388152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist