Provider Demographics
NPI:1386023844
Name:NEW YORK EYE CARE & SURGERY PC
Entity Type:Organization
Organization Name:NEW YORK EYE CARE & SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:KHODADADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-773-6388
Mailing Address - Street 1:18 FRANKLIN PL
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1229
Mailing Address - Country:US
Mailing Address - Phone:516-829-2020
Mailing Address - Fax:516-829-2026
Practice Address - Street 1:287 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4700
Practice Address - Country:US
Practice Address - Phone:516-829-2020
Practice Address - Fax:516-829-2026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206436207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty