Provider Demographics
NPI:1760685481
Name:PEDIATRIC OPHTHALMOLOGY OF GREATER NY, PC
Entity Type:Organization
Organization Name:PEDIATRIC OPHTHALMOLOGY OF GREATER NY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PINCHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-487-0410
Mailing Address - Street 1:1000 NORTHERN BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5312
Mailing Address - Country:US
Mailing Address - Phone:516-487-0410
Mailing Address - Fax:516-466-8563
Practice Address - Street 1:1000 NORTHERN BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5312
Practice Address - Country:US
Practice Address - Phone:516-487-0410
Practice Address - Fax:516-466-8563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158139207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty