Provider Demographics
NPI:1760853402
Name:CHELSEA EYE OPHTHALMOLOGY, PLLC
Entity Type:Organization
Organization Name:CHELSEA EYE OPHTHALMOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:COAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-727-3717
Mailing Address - Street 1:157 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4102
Mailing Address - Country:US
Mailing Address - Phone:212-727-3717
Mailing Address - Fax:212-727-3789
Practice Address - Street 1:157 W 19TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4102
Practice Address - Country:US
Practice Address - Phone:212-727-3717
Practice Address - Fax:212-727-3789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY158010-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty