Provider Demographics
NPI:1467103499
Name:SUNSET EYECARE PC
Entity Type:Organization
Organization Name:SUNSET EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-708-4184
Mailing Address - Street 1:1148 DEER PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-3102
Mailing Address - Country:US
Mailing Address - Phone:631-242-0808
Mailing Address - Fax:631-272-3683
Practice Address - Street 1:1148 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-3102
Practice Address - Country:US
Practice Address - Phone:631-242-0808
Practice Address - Fax:631-272-3683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty