Provider Demographics
NPI:1639353782
Name:SCHENECTADY EYE SURGERY ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:SCHENECTADY EYE SURGERY ASSOCIATES, PLLC
Other - Org Name:SCHENECTADY EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:LONGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-374-0483
Mailing Address - Street 1:1201 NOTT ST
Mailing Address - Street 2:STE. 105
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-2589
Mailing Address - Country:US
Mailing Address - Phone:518-374-0483
Mailing Address - Fax:518-374-0515
Practice Address - Street 1:1201 NOTT ST
Practice Address - Street 2:STE. 105
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308-2589
Practice Address - Country:US
Practice Address - Phone:518-374-0483
Practice Address - Fax:518-374-0515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB83034Medicare UPIN