Provider Demographics
NPI:1609429414
Name:SATIJA VISION CARE OPTOMETRY, P.C.
Entity Type:Organization
Organization Name:SATIJA VISION CARE OPTOMETRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SATIJA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:530-713-3191
Mailing Address - Street 1:404 E 117TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-5020
Mailing Address - Country:US
Mailing Address - Phone:530-713-3191
Mailing Address - Fax:
Practice Address - Street 1:404 E 117TH ST FL 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-5020
Practice Address - Country:US
Practice Address - Phone:347-757-5475
Practice Address - Fax:646-381-3639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-21
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03856411Medicaid