Provider Demographics
NPI:1376724302
Name:FZOAD.COM ENTERPRISES INC.
Entity Type:Organization
Organization Name:FZOAD.COM ENTERPRISES INC.
Other - Org Name:MANHATTAN EYEWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-243-5898
Mailing Address - Street 1:241 W 23RD ST
Mailing Address - Street 2:MANHATTAN EYEWORKS-GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2320
Mailing Address - Country:US
Mailing Address - Phone:212-243-5898
Mailing Address - Fax:
Practice Address - Street 1:241 W 23RD ST
Practice Address - Street 2:MANHATTAN EYEWORKS-GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2320
Practice Address - Country:US
Practice Address - Phone:212-243-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY4780305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100001453Medicare PIN