Provider Demographics
NPI:1598852246
Name:EYE SURGEONS AND PHYSICIANS, PC
Entity Type:Organization
Organization Name:EYE SURGEONS AND PHYSICIANS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:COLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-486-4742
Mailing Address - Street 1:6080 JERICHO TPKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-2850
Mailing Address - Country:US
Mailing Address - Phone:631-486-4742
Mailing Address - Fax:631-486-4745
Practice Address - Street 1:6080 JERICHO TPKE
Practice Address - Street 2:SUITE 102
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2850
Practice Address - Country:US
Practice Address - Phone:631-486-4742
Practice Address - Fax:631-486-4745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF34624Medicare UPIN
NYG83995Medicare UPIN