Provider Demographics
NPI:1639396633
Name:LONG ISLAND EYE PHYSICIANS & SURGEONS,PC
Entity Type:Organization
Organization Name:LONG ISLAND EYE PHYSICIANS & SURGEONS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:SAUL
Authorized Official - Last Name:STOLLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-473-5329
Mailing Address - Street 1:251 E OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-2166
Mailing Address - Country:US
Mailing Address - Phone:631-473-5329
Mailing Address - Fax:631-473-5371
Practice Address - Street 1:251 E OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2166
Practice Address - Country:US
Practice Address - Phone:631-473-5329
Practice Address - Fax:631-473-5371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty