Provider Demographics
NPI:1619058484
Name:SWEIG, JILL S (OD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:S
Last Name:SWEIG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:OYSTER BAY
Mailing Address - State:NY
Mailing Address - Zip Code:11771-2213
Mailing Address - Country:US
Mailing Address - Phone:516-922-0640
Mailing Address - Fax:516-922-6906
Practice Address - Street 1:101 SOUTH ST
Practice Address - Street 2:
Practice Address - City:OYSTER BAY
Practice Address - State:NY
Practice Address - Zip Code:11771-2213
Practice Address - Country:US
Practice Address - Phone:516-922-0640
Practice Address - Fax:516-922-6906
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2023-09-28
Deactivation Date:2023-05-17
Deactivation Code:
Reactivation Date:2023-09-28
Provider Licenses
StateLicense IDTaxonomies
NYTUV005528152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY159OtherDAVIS VISION/ CSEA
NY02553OtherSPECTRA VISION
NY912973OtherBLOCK VISION
NY6700198OtherGHI
NY783991OtherAETNA US HEALTHCARE
NY107526POtherHIP
NY783991OtherAETNA US HEALTHCARE
NY107526POtherHIP