Provider Demographics
NPI:1497845945
Name:EPSTEIN, GEORGE
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 NORTH MAIN ST
Mailing Address - Street 2:EYEGUYS OPTICAL
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977
Mailing Address - Country:US
Mailing Address - Phone:845-352-2878
Mailing Address - Fax:845-352-7154
Practice Address - Street 1:291 NORTH MAIN STREET
Practice Address - Street 2:C/O EYEGUYS OPTICAL
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977
Practice Address - Country:US
Practice Address - Phone:845-352-2878
Practice Address - Fax:845-352-7154
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00583.01156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY921581OtherBLOCK VISION
NY49903OtherDAVIS VISION
NY0128006Medicaid