Provider Demographics
NPI:1700188620
Name:LASIK OF NEW YORK PLLC
Entity Type:Organization
Organization Name:LASIK OF NEW YORK PLLC
Other - Org Name:MANHATTAN LASIK CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SINGLE MEMBER / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVORK
Authorized Official - Middle Name:
Authorized Official - Last Name:NIKSARLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-759-7500
Mailing Address - Street 1:110 E 55TH ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-4540
Mailing Address - Country:US
Mailing Address - Phone:212-759-7500
Mailing Address - Fax:212-759-7505
Practice Address - Street 1:110 E 55TH ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4540
Practice Address - Country:US
Practice Address - Phone:212-759-7500
Practice Address - Fax:212-759-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-29
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238273207W00000X
NY201205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty