Provider Demographics
NPI:1477651271
Name:CNY EYE PHYSICIANS AND SURGEONS PC
Entity Type:Organization
Organization Name:CNY EYE PHYSICIANS AND SURGEONS PC
Other - Org Name:CNY EYE PHYSICIANS AND SURGEONS, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-735-8358
Mailing Address - Street 1:2206 GENESEE STREET
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5829
Mailing Address - Country:US
Mailing Address - Phone:315-735-8358
Mailing Address - Fax:315-735-0031
Practice Address - Street 1:2206 GENESEE STREET
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-5829
Practice Address - Country:US
Practice Address - Phone:315-735-8358
Practice Address - Fax:315-735-0031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50553AMedicare PIN
NY50553AMedicare ID - Type Unspecified