Provider Demographics
NPI:1821243791
Name:ELINOR B DESCOVICH, O.D., P.C.
Entity Type:Organization
Organization Name:ELINOR B DESCOVICH, O.D., P.C.
Other - Org Name:NEW PALTZ EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELINOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DESCOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:845-255-8370
Mailing Address - Street 1:188 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1238
Mailing Address - Country:US
Mailing Address - Phone:845-255-8370
Mailing Address - Fax:845-255-6329
Practice Address - Street 1:188 MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1238
Practice Address - Country:US
Practice Address - Phone:845-255-8370
Practice Address - Fax:845-255-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005081152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty