Provider Demographics
NPI:1629222641
Name:GLAUCOMA ASSOCIATES OF NEW YORK, P.C.
Entity Type:Organization
Organization Name:GLAUCOMA ASSOCIATES OF NEW YORK, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:SERKADIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-477-7540
Mailing Address - Street 1:310 E 14TH ST
Mailing Address - Street 2:SUITE 304 SO
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4201
Mailing Address - Country:US
Mailing Address - Phone:646-521-0264
Mailing Address - Fax:
Practice Address - Street 1:121 E 60TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1117
Practice Address - Country:US
Practice Address - Phone:212-477-7540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLAUCOMA ASSOCIATES OF NEW YORK, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty