Provider Demographics
NPI:1598937013
Name:EYE CENTER OF WESTCHESTER M D P C
Entity Type:Organization
Organization Name:EYE CENTER OF WESTCHESTER M D P C
Other - Org Name:JONATHAN M KAGAN, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-570-6300
Mailing Address - Street 1:751 KIMBALL AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1534
Mailing Address - Country:US
Mailing Address - Phone:914-237-4700
Mailing Address - Fax:914-237-1354
Practice Address - Street 1:751 KIMBALL AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-1534
Practice Address - Country:US
Practice Address - Phone:914-237-4700
Practice Address - Fax:914-237-1354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112332207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00203241Medicaid
1182610001Medicare NSC
A65126Medicare UPIN
73T261Medicare PIN
965651Medicare PIN