Provider Demographics
NPI:1346786589
Name:ABOUBACAR SANGARE
Entity Type:Organization
Organization Name:ABOUBACAR SANGARE
Other - Org Name:PRIMARY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABOUBACAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-627-3557
Mailing Address - Street 1:1108 RUTLAND RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3646
Mailing Address - Country:US
Mailing Address - Phone:718-627-3557
Mailing Address - Fax:
Practice Address - Street 1:1108 RUTLAND RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3646
Practice Address - Country:US
Practice Address - Phone:718-627-3557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-11
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTU005004152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty