Provider Demographics
NPI:1710399142
Name:EYES ON HEALTH PC
Entity Type:Organization
Organization Name:EYES ON HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKKASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-336-3937
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-0279
Mailing Address - Country:US
Mailing Address - Phone:248-336-3937
Mailing Address - Fax:248-336-3938
Practice Address - Street 1:22039 JOHN R RD
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-1712
Practice Address - Country:US
Practice Address - Phone:248-336-3937
Practice Address - Fax:248-336-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092004152W00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty