Provider Demographics
NPI:1639258148
Name:HERALD SQUARE OPTOMETRIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:HERALD SQUARE OPTOMETRIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:212-967-4177
Mailing Address - Street 1:901 AVENUE OF THE AMERICAS
Mailing Address - Street 2:MANHATTAN MALL, LEVEL C-2, INSIDE LENSCRAFTERS
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3505
Mailing Address - Country:US
Mailing Address - Phone:212-967-4177
Mailing Address - Fax:212-967-2101
Practice Address - Street 1:901 AVENUE OF THE AMERICAS
Practice Address - Street 2:MANHATTAN MALL, LEVEL C-2, INSIDE LENSCRAFTERS
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3505
Practice Address - Country:US
Practice Address - Phone:212-967-4177
Practice Address - Fax:212-967-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV-5241152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty