Provider Demographics
NPI:1851560551
Name:DR BURT S ESCHEN PC
Entity Type:Organization
Organization Name:DR BURT S ESCHEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BURT
Authorized Official - Middle Name:S
Authorized Official - Last Name:ESCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:718-648-0964
Mailing Address - Street 1:2821 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5053
Mailing Address - Country:US
Mailing Address - Phone:718-648-0964
Mailing Address - Fax:718-616-0575
Practice Address - Street 1:2821 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5053
Practice Address - Country:US
Practice Address - Phone:718-648-0964
Practice Address - Fax:718-616-0575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV003441-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC26931Medicare PIN