Provider Demographics
NPI:1639218837
Name:CONTACT LENS CENTER OF ROCKLAND
Entity Type:Organization
Organization Name:CONTACT LENS CENTER OF ROCKLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:ULXSSES
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:ECONS
Authorized Official - Suffix:
Authorized Official - Credentials:OPTHALMIC DISPENSER
Authorized Official - Phone:845-634-8816
Mailing Address - Street 1:70 SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3514
Mailing Address - Country:US
Mailing Address - Phone:845-634-8816
Mailing Address - Fax:
Practice Address - Street 1:70 SOUTH MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3514
Practice Address - Country:US
Practice Address - Phone:845-634-8816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2784156FC0801X, 156FX1100X
156FX1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens FitterGroup - Multi-Specialty
Not Answered156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Multi-Specialty
Not Answered156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0451900001Medicare ID - Type Unspecified