Provider Demographics
NPI:1346642352
Name:NISSIRIOS OPHTHALMOLOGY PC
Entity Type:Organization
Organization Name:NISSIRIOS OPHTHALMOLOGY PC
Other - Org Name:METROEYEMD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:NISSIRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-893-1386
Mailing Address - Street 1:20020 44TH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2658
Mailing Address - Country:US
Mailing Address - Phone:718-423-2020
Mailing Address - Fax:718-504-7379
Practice Address - Street 1:20020 44TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2658
Practice Address - Country:US
Practice Address - Phone:718-423-2020
Practice Address - Fax:718-504-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty