Provider Demographics
NPI:1790407708
Name:EYE CARE MEDICAL PC
Entity Type:Organization
Organization Name:EYE CARE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPOPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-634-6815
Mailing Address - Street 1:455 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-3331
Mailing Address - Country:US
Mailing Address - Phone:212-368-2020
Mailing Address - Fax:212-368-2029
Practice Address - Street 1:455 LENOX AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-3331
Practice Address - Country:US
Practice Address - Phone:631-933-3601
Practice Address - Fax:212-368-2029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-15
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty