Provider Demographics
NPI:1467558767
Name:WARSHAY, JEFFREY P (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:WARSHAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 TUCKAHOE RD
Mailing Address - Street 2:#1B
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5713
Mailing Address - Country:US
Mailing Address - Phone:914-337-7775
Mailing Address - Fax:914-337-0845
Practice Address - Street 1:598 TUCKAHOE RD
Practice Address - Street 2:#1B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5713
Practice Address - Country:US
Practice Address - Phone:914-337-7775
Practice Address - Fax:914-337-0845
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004482-1152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00973551Medicaid
NYC31931Medicare ID - Type Unspecified
NY00973551Medicaid
NY0541170001Medicare NSC