Provider Demographics
NPI:1548410392
Name:EYE Q OPTOMETRIST PC
Entity Type:Organization
Organization Name:EYE Q OPTOMETRIST PC
Other - Org Name:EYE Q OPTOMETRIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZLATIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:914-472-5932
Mailing Address - Street 1:1130 WILMOT RD.
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-472-5932
Mailing Address - Fax:914-472-7485
Practice Address - Street 1:381 AMSTERDAM AVE.
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-724-8855
Practice Address - Fax:212-724-8081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCAWND1Medicare PIN